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Abstract Background Hepatic inflammation in patients with hepatocellular carcinoma (HCC) remains unclear. This study aimed to construct a clinically expedient predictive model to grade hepatic inflammation in HCC patients. Methods This is a two-center retrospective cohort study of HCC patients comprising Derivation cohort and External Validation cohort of 1201 and 505 patients, respectively. Variables of liver inflammation identified through uni- and multi-variate logistic regression analyses were incorporated into predictive nomograms and applied to Derivation cohort, subject to internal and external validation. Results Liver fibrosis severity score, portal hypertension severity, and model for end-stage liver disease-sodium independently predicted hepatic inflammation grade. Performance for distinguishing G1 and non-G1 (≥ G2) patients was good with C-index of 0.810 and 0.817 in Derivation and External Validation cohort, respectively. The nomogram performed poorly to predict grade G2, G3 and G2 + G3, but performed well to predict G4. Conclusions Our nomogram exhibited good performance for scaling hepatic inflammation (G1 and G4) in HCC, and could be employed as adjunctive diagnostic tools to guide HCC management strategy.

Abstract Background N-acetyltransferase 10 (NAT10) plays a crucial role in the occurrence and development of various tumors. However, the current regulatory mechanism of NAT10 in tumors is limited to its presence in tumor cells. Here, we aimed to reveal the role of NAT10 in intrahepatic cholangiocarcinoma (ICC) and investigate its effect on macrophage polarization in the tumor microenvironment (TME). Methods The correlation between NAT10 and ICC clinicopathology was analyzed using tissue microarray (TMA), while the effect of NAT10 on ICC proliferation was verified in vitro and in vivo. Additionally, the downstream target of NAT10, C-C motif chemokine ligand 2 (CCL2), was identified by Oxford Nanopore Technologies full-length transcriptome sequencing, RNA immunoprecipitation-quantitative polymerase chain reaction, and coimmunoprecipitation experiments. It was confirmed by co-culture that ICC cells could polarize macrophages towards M2 type through the influence of NAT10 on CCL2 protein expression level. Through RNA-sequencing, molecular docking, and surface plasmon resonance (SPR) assays, it was confirmed that berberine (BBR) can specifically bind CCL2 to inhibit ICC development. Results High expression level of NAT10 was associated with poor clinicopathological manifestations of ICC. In vitro, the knockdown of NAT10 inhibited the proliferative activity of ICC cells and tumor growth in vivo, while its overexpression promoted ICC proliferation. Mechanically, by binding to CCL2 messenger RNA, NAT10 increased CCL2 protein expression level in ICC and their extracellular matrix, thereby promoting the proliferation of ICC cells and M2-type polarization of macrophages. BBR can target CCL2, inhibit ICC proliferation, and reduce M2-type polarization of macrophages. Conclusions NAT10 promotes ICC proliferation and M2-type polarization of macrophages by up-regulating CCL2, whereas BBR inhibits ICC proliferation and M2-type polarization of macrophages by inhibiting CCL2.

Hepatocellular carcinoma (HCC) is a high-incidence, poor-prognosis malignancy worldwide, requiring new strategies for treatment. Ubiquitination, especially ubiquitination through E3 ubiquitin ligases, plays an indispensable role in the development and progression of HCC. E3 ubiquitin ligases are crucial enzymes in ubiquitination, controlling the degradation of specific substrate proteins and influencing various cellular functions, such as tumor cell proliferation, apoptosis, migration, and immune evasion. In this review, we systematically summarize the mechanisms of E3 ubiquitin ligases in HCC, with a focus on the significance of RING, HECT, and RBR types in HCC progression. The review also looks at the potential for targeting E3 ligases to modulate the tumor microenvironment (TME) and increase immunotherapy efficacy. Future studies will optimize HCC treatment by formulating specific inhibitors or approaches that will be based on gene therapy targeting E3 ligases in order to overcome resistance issues with present treatments and create optimism in the journey of treatment for HCC patients.

In the context of improving living standards, the management of people’s mental health is gaining increasing attention. Despite the proven significance of urban green space in stress alleviation and mental well-being, research on the link among perception-based landscape elements, perception-based ecosystem services and users’ happiness in national parks remains further studied. This study focused on Beijing, one of the world’s most densely populated cities, to study factors influencing happiness among park users for management. Based on cognitive appraisal theory, this study proposed the indicator framework for park management and used the structural equation model to explore how perception-based landscape elements and perception-based ecosystem services directly or indirectly affect the well-being of national park users. The results showed that the happiness of park users was relatively high (4.3 out of 5). Landscape elements such as surfacing (0.632), resting seats (0.567), water bodies (0.555), and vegetation (0.549), as well as ecosystem services such as inspiration (0.691), rest (0.649), and cool climate (0.649), had a stronger association with happiness. The study reveals that landscape elements in the national parks directly and indirectly affect users’ happiness, including directly affecting their happiness and indirectly affecting their happiness through ecosystem services. There are three types of user groups, including solo park wanderers (38.5%), social frequent users (29.7%), and independent casual users (31.8%), with consistent impact pathways of landscape elements and ecosystem services on happiness. However, there are variations in the magnitude of impact and the pathways influenced by socio-economic factors. Based on these findings, this study provided targeted suggestions for national park planning and design, and served as a reference for the study of users’ happiness in other urban spaces. Furthermore, this study consolidates the cognitive evaluation theory, and sheds light on the role of perception-based appraisal landscape elements and ecosystem services in user happiness.

Abstract Background/purpose This study compared the clinical efficacy and safety of laparoscopic versus open resection for hilar cholangiocarcinoma (HCCA) and analyzed potential prognostic factors. Methods The study included patients who underwent HCCA resection at our center from March 2012 to February 2022. Perioperative complications and postoperative prognosis were compared between the laparoscopic surgery (LS) and open surgery (OS) groups. Results After screening 313 HCCA patients, 68 patients were eligible for the study in the LS group (n = 40) and OS group (n = 28). Kaplan-Meier survival curve analysis revealed that overall survival > 2 years and 3-year disease-free survival (DFS) were more common in the LS than OS group, but the rate of 2-year DFS was lower in the LS group than OS group. Cox multivariate regression analysis revealed age (< 65 years), radical resection, and postoperative adjuvant therapy were associated with reduced risk of death (hazard ratio [HR] = 0.380, 95% confidence interval [CI] = 0.150–0.940, P = 0.036; HR = 0.080, 95% CI = 0.010–0.710, P = 0.024 and HR = 0.380, 95% CI = 0.150–0.960, P = 0.040), whereas preoperative biliary drainage was an independent factor associated with increased risk of death (HR = 2.810, 95% CI = 1.130–6.950, P = 0.026). Perineuronal invasion was identified as an independent risk factor affecting DFS (HR = 5.180, 95% CI = 1.170–22.960, P = 0.030). Conclusions Compared with OS, laparoscopic HCCA resection does not significantly differ in terms of clinical efficacy. Age (

Abstract Background Radical resection is still the most cost-effectiveness curative strategy for intrahepatic cholangiocarcinoma (ICC), but it remains controversial on the survival benefit of anatomic resection (AR). In this study, we sought to compare the oncologic outcomes between AR versus non-AR (NAR) as the primary treatment for early-stage ICC patients. Methods Data of ICC patients who underwent hepatectomy and staged at AJCC I were retrospectively collected from 12 hepatobiliary centers in China between Dec 2012 and Dec 2015. Propensity score matching (PSM) and stabilized inverse probability of treatment weighting (IPTW) analysis were performed to minimize the effect of potential confounders, and the perioperative and long-term outcomes between AR and NAR groups were compared. Results Two hundred seventy-eight ICC patients staged at AJCC I were eligible for this study, including 126 patients receiving AR and 152 patients receiving NAR. Compared to the NAR group, the AR group experienced more intraoperative blood loss before and after PSM or stabilized IPTW (all P > 0.05); AR group also experienced more intraoperative transfusion after stabilized IPTW (P > 0.05). In terms of disease-free survival (DFS) and overall survival (OS), no significant differences were observed between the two groups before and after PSM or stabilized IPTW (all P > 0.05). Multivariable Cox regression analyses found that AR was not an independent prognostic factor for either DFS or OS (all P > 0.05). Further analysis also showed that the survival benefit of AR was not found in any subgroup stratified by Child–Pugh grade (A or B), cirrhosis (presence or absence), tumor diameter (≤ 5 cm or > 5 cm) and pathological type (mass-forming or non-mass-forming) with all P > 0.05. Conclusion Surgical approach does not influence the prognosis of patients with stage I primary ICC, and NAR might be acceptable and oncological safety.

Abstract Lymph nodes play a pivotal role in tumor progression as key components of the lymphatic system. However, the unique physiological structure of lymph nodes has traditionally constrained the drug delivery efficiency. Excitingly, nanomedicines have shown tremendous advantages in lymph node-specific delivery, enabling distinct recognition and diagnosis of lymph nodes, and hence laying the foundation for efficient tumor therapies. In this review, we comprehensively discuss the key factors affecting the specific enrichment of nanomedicines in lymph nodes, and systematically summarize nanomedicines for precise lymph node drug delivery and therapeutic application, including the lymphatic diagnosis and treatment nanodrugs and lymph node specific imaging and identification system. Notably, we delve into the critical challenges and considerations currently facing lymphatic nanomedicines, and futher propose effective strategies to address these issues. This review encapsulates recent findings, clinical applications, and future prospects for designing effective nanocarriers for lymphatic system targeting, with potential implications for improving cancer treatment strategies.

IntroductionThe fragility of agriculture makes the food supply chain vulnerable to external risks such as epidemic, conflict, disaster, climate change, economic and energy crisis. The COVID-19 pandemic has spread and continued globally in recent years, resulting in food supply chain disruption and insecurity, which triggers profound reflection on the impacts of public health events (PHEs). Studying the impacts of PHEs on the resilience of food supply chain has great significance to effectively reduce the risks of disruption and insecurity in the future.MethodsBased on the composition of PHEs and the division of food supply chain, this paper adopted the nonlinear Granger causality test to verify the nonlinear causal relationship between PHEs and proxy variables in the food supply chain; then the TVP-VAR-SV model was constructed and its three-dimensional pulse response results were matched with the sensitivity, recovery, and adaptation of the food supply chain resilience to deeply explore the dynamic impacts of PHEs.ResultsPHEs has significant nonlinear conduction effects on the resilience of food supply chain, the impacts of PHEs on the partial sector resilience have significant dynamic characteristics in the whole sample period, and the impacts of PHEs on the recovery and adaptation aspects of food supply chain resilience have structural break characteristics.DiscussionThe differences, dynamic characteristics and structural breaks of the impacts of PHEs on the resilience of food supply chain are caused by the infectivity and mortality of PHEs, attributes of food products, regulation of supply and demand in the market, behavioral decisions of all participants, changes in the policy environment, and coordination and upgrading of all sectors in the supply chain.

Abstract Background Laparoscopic surgery (LS) has been increasingly applied in perihilar cholangiocarcinoma (pCCA). In this study, we intend to compare the short-term outcomes of LS versus open operation (OP) for pCCA in a multicentric practice in China. Methods This real-world analysis included 645 pCCA patients receiving LS and OP at 11 participating centers in China between January 2013 and January 2019. A comparative analysis was performed before and after propensity score matching (PSM) in LS and OP groups, and within Bismuth subgroups. Univariate and multivariate models were performed to identify significant prognostic factors of adverse surgical outcomes and postoperative length of stay (LOS). Results Among 645 pCCAs, 256 received LS and 389 received OP. Reduced hepaticojejunostomy (30.89% vs 51.40%, P = 0.006), biliary plasty requirement (19.51% vs 40.16%, P = 0.001), shorter LOS (mean 14.32 vs 17.95 d, P 0.05 for all). After PSM, the short-term outcomes of two surgical methods were similar, except for shorter LOS in LS compared with OP (mean 15.19 vs 18.48 d, P = 0.0007). A series subgroup analysis demonstrated that LS was safe and had advantages in shorting LOS. Conclusion Although the complex surgical procedures, LS generally seems to be safe and feasible for experienced surgeons. Trial registration NCT05402618 (date of first registration: 02/06/2022).

316L stainless steel pipes are widely used in the storage and transportation of low-temperature media due to their excellent low-temperature mechanical properties and corrosion resistance. However, due to their low thermal conductivity and large coefficient of linear expansion, they often lead to significant welding residual tensile stress and thermal cracks in the weld seam. This also poses many challenges for their secure and reliable applications. In order to effectively control the crack defects caused by stress concentration near the heat-affected zone of the weld, this paper establishes a thermal elastoplastic three-dimensional finite element (FE) model, constructs a welding heat source, and simulates and studies the influence of process parameters on the residual stress around the pipeline circumference and axial direction in the heat-affected zone. Comparison and verification were conducted using simulation and experimental methods, respectively, proving the rationality of the finite element model establishment. The axial and circumferential residual stress distribution obtained by the simulation method did not have an average deviation of more than 30 MPa from the numerical values obtained by the experimental method. This study also considers the effects of welding energy, welding speed, and welding start position on the pipe’s circumferential and axial residual stress laws. The results indicate that changes in welding energy and welding speed have almost no effect on the longitudinal residual stress but have a more significant effect on the transverse residual stress. The maximum transverse residual stress is reached at a welding energy of 1007.4~859.3 J/mm and a welding speed of 6.6 mm/s. Various interlayer arc-striking deflection angles can impact the cyclic phase angle of the transverse residual stress distribution in the seam center, but they do not alter its cyclic pattern. They do influence the amplitude and distribution of the longitudinal residual stress along the circumference. The residual stress distribution on the surface of the pipe fitting is homogenized and improved at 120°.

BackgroundBecker muscular dystrophy (BMD) is an inherited X-linked recessive condition resulting from mutations of the DMD gene encoding dystrophin. Left ventricular noncompaction (LVNC) is a rare cardiomyopathy morphologically characterized by abnormal myocardial trabeculae and deep recesses in the left ventricle. LVNC in BMD patients has only rarely been reported.Case reportIn the present study, we identified a deletion mutation in exons 10 to 12 (EX10_12 del) of the DMD gene (reference sequence NM_004006.2) in two Chinese siblings with BMD and LVNC by high throughput targeted next-generation sequencing (NGS) and quantitative polymerase chain reaction (qPCR). The proband was a 22-year-old man admitted with dyspnea, abdominal distention, and polyserositis. It is noteworthy that both the proband and his younger brother manifested progressive muscular atrophy and creatine kinase (CK) elevation. Light and electron microscopy examination of muscle biopsies showed the typical features of dystrophinopathies. Cardiac magnetic resonance imaging and echocardiography demonstrated that both brothers had an enlarged left ventricle, LVNC, and reduced left ventricular ejection fraction. Finally, the proband underwent heart transplantation at age 26 with an event-free follow-up over 4 years post-transplantation.ConclusionThis case further enriches our knowledge of the symptoms, genotype, cardiac performance, management, and prognosis of BMD patients complicated by LVNC. It is recommended that early comprehensive cardiac evaluation should be considered for patients with BMD to exclude LVNC, as this may have a significant impact on their prognosis.

Abstract Background and purpose Index cholecystectomy is insufficient for curing T3 incidental gallbladder cancer (IGC), and once residual cancer (RC) is found, the prognosis is often poor. The purpose of this study was to investigate the effect of RC on the prognosis and the optimal choice of adjuvant therapy for R0 reresection patients with T3 IGC. Methods We retrospectively reviewed data from patients with T3 IGC who underwent radical reresection from January 2013 to December 2018. RC was defined as histologically proven cancer at reresection. Demographics and tumour treatment-related variables were analysed in correlation with RC and survival. Adjuvant (Adj) chemoradiotherapy (CRT) was correlated with overall survival (OS) and disease-free survival (DFS). Results Of the 167 patients with IGC who underwent surgery, 102 underwent radical extended resection. Thirty-two (31.4%) RCs were found. Hepatic side tumours (T3h) and both side tumours (T3h + T3p) were associated with the presence of RC. In multivariate analysis, RC and lymph node metastasis were independent prognostic factors for DFS and OS (P

The rapid urbanization process has gradually deepened its role in the sustainable development of agriculture, especially in the sustainable supply of food in poor areas, and has attracted more attention from international academic circles. However, the impact mechanism of different dimensions of urbanization on food sustainability in poor areas has not yet been fully unpacked. Therefore, this study focuses on potatoes as a specialty food mainly grown in poor areas of China, explores the impact mechanism of urbanization on the carbon emission intensity of potato production (CEIPP) with the spatial Durbin model, and compares with the carbon emission intensity of staple grain (CEISG) results. The main conclusions are as follows: the urbanization of main potato-producing areas developed rapidly from 2002 to 2020, which is in line with the decrease in CEIPP. The decrease in CEIPP has a significant impact on slowing down the growth of total carbon emissions and has greater potential for reduction, especially in Central and Western China, which has a large poverty-stricken population. Compared with traditional staple grain, urbanization has become a key factor influencing CEIPP. The results indicate that different dimensions of urbanization have varying degrees of impact on the sustainable production of regional specialty foods in China. The improvement of comprehensive urbanization, population urbanization, and economic urbanization reduces CEIPP, while land urbanization increases CEIPP. Therefore, to reduce CEIPP and promote its sustainable development, it is necessary to improve population urbanization and economic urbanization, properly avoid the disorderly expansion of land urbanization, and improve the quality and level of comprehensive urbanization.

Focusing on the problem of strip shape quality control in the finishing process of hot rolling, a shape model based on metal flow and stress release with the application of varying contact rolling parameters is introduced. Combined with digital twin technology, the digital twin framework of the shape model is proposed, which realizes the deep integration between physical time–space and virtual time–space. With the utilization of the historical data, the parameters are optimized iteratively to complete the digital twin of the shape model. According to the schedule, the raw material information is taken as the input to obtain the simulation of the strip shape, which shows a variety of export shape conditions. The prediction absolute error of the crown and flatness are less than 5 μm and 5 I-unit, respectively. The results prove that the proposed shape simulation model with strong prediction performance can be effectively applied to hot rolling production. In addition, the proposed model provides operators with a reference for the parameter settings for actual production and promotes the intelligent application of a shape control strategy.

Abstract Background Hepatectomy is currently the most effective modality for the treatment of intrahepatic cholangiocarcinoma (ICC). The status of the lymph nodes directly affects the choice of surgical method and the formulation of postoperative treatment plans. Therefore, a preoperative judgment of lymph node status is of great significance for patients diagnosed with this condition. Previous prediction models mostly adopted logistic regression modeling, and few relevant studies applied random forests in the prediction of ICC lymph node metastasis (LNM). Methods A total of 149 ICC patients who met clinical conditions were enrolled in the training group. Taking into account preoperative clinical data and imaging features, 21 indicators were included for analysis and modeling. Logistic regression was used to filter variables through multivariate analysis, and random forest regression was used to rank the importance of these variables through the use of algorithms. The model’s prediction accuracy was assessed by the concordance index (C-index) and calibration curve and validated with external data. Result Multivariate analysis shows that Carcinoembryonic antigen (CEA), Carbohydrate antigen19-9 (CA19-9), and lymphadenopathy on imaging are independent risk factors for lymph node metastasis. The random forest algorithm identifies the top four risk factors as CEA, CA19-9, and lymphadenopathy on imaging and Aspartate Transaminase (AST). The predictive power of random forest is significantly better than the nomogram established by logistic regression in both the validation group and the training group (Area Under Curve reached 0.758 in the validation group). Conclusions We constructed a random forest model for predicting lymph node metastasis that, compared with the traditional nomogram, has higher prediction accuracy and simultaneously plays an auxiliary role in imaging examinations.

Abstract Background Applying traditional fluorescence navigation technologies in hepatocellular carcinoma is severely restricted by high false-positive rates, variable tumor differentiation, and unstable fluorescence performance. Results In this study, a green, economical and safe nanomedicine formulation technology was developed to construct carrier-free indocyanine green nanoparticles (nanoICG) with a small uniform size and better fluorescent properties without any molecular structure changes compared to the ICG molecule. Subsequently, nanoICG dispersed into lipiodol via a super-stable homogeneous intermixed formulation technology (SHIFT&nanoICG) for transhepatic arterial embolization combined with fluorescent laparoscopic hepatectomy to eliminate the existing shortcomings. A 52-year-old liver cancer patient was recruited for the clinical trial of SHIFT&nanoICG. We demonstrate that SHIFT&nanoICG could accurately identify and mark the lesion with excellent stability, embolism, optical imaging performance, and higher tumor-to-normal tissue ratio, especially in the detection of the microsatellite lesions (0.4 × 0.3 cm), which could not be detected by preoperative imaging, to realize a complete resection of hepatocellular carcinoma under fluorescence laparoscopy in a shorter period (within 2 h) and with less intraoperative blood loss (50 mL). Conclusions This simple and effective strategy integrates the diagnosis and treatment of hepatocellular carcinoma, and thus, it has great potential in various clinical applications.

Recently, COVID-19 pandemic, locust plague, drought and conflict have seriously affected the development of agriculture in Africa, which make Africa countries difficultly to achieve the Sustainable Development Goals (SDGs) 1 and 2. As the cornerstone of agricultural development, technological progress has made brilliant contributions to achieving food security and nutrition improvement in African countries. And as the largest economic and trade partner of Africa, analyzing the agricultural technology gap between China and African countries and exploring optimal paths also has great significance for achieving SDGs 8 and 9. Therefore, the paper used the Meta-frontier SBM model to measure the agricultural technology gap between China and African countries from 2003 to 2019, and explores sources of the gap. On this basis, 24 African countries were taken as samples to identify multiple paths for narrowing the technology gap between China and Africa with the help of the configuration analysis method of the fuzzy-set qualitative comparative analysis (fsQCA). The results showed that the overall agricultural technology gap between China and Africa was narrowing, which was mainly caused by the reduction of pure technical inefficiency. However, sources of technology gap in African countries with different economic development levels were different. Configuration analysis found that agricultural technology innovation and institutional environment were the key conditional variables to narrow the agricultural technology gap between China and Africa. Five paths had been formed around two key conditional variables, and further summarized into three driving modes: “technology-environment” driving mode, “technology-organization” driving mode and “organization-environment” driving mode. Furthermore, this paper explored the multiple concurrent causality of narrowing the technology gap, which overcomes the deficiency of using regression methods. The paper highlights the importance of enhancing the integration of technical, organizational, and environmental conditions in African countries to collectively advance agricultural scientific and technological progress

Abstract The clinical applications of transcatheter arterial embolization (TAE) conversion therapy combined with hepatectomy have been severely restricted by ill‐defined tumoral boundaries and miniscule hidden lesions. Fluorescent surgical navigation is a promising method for overcoming these barriers. However, sufficient delivery of the fluorescent probe into the tumor region after long‐term TAE is challenging due to blockade of the tumor‐supplying artery. Here, a super‐stable homogeneous intermix formulating technology (SHIFT) to physically mix lipiodol and indocyanine green (ICG) formulation (SHIFT and ICG) for fluorescent surgical navigation after long‐term TAE conversion therapy is provided. Through the retrospective study of 45 clinical liver cancer patients, it is found that SHIFT and ICG formulation have excellent tumor deposition effect and safety. During surgical resection after long‐term TAE conversion therapy, SHIFT and ICG could clearly identify in real time the full tumor regions and boundaries and had a high signal‐to‐normal tissues ratio—even the indistinguishable satellite lesions could be identified with a strong fluorescence intensity. Meanwhile, SHIFT and ICG could improve operative, anesthetic, and postoperative variables associated with postoperative complications. This simple and effective SHIFT could provide precise fluorescent navigation for surgical resection following long‐term embolization therapy in clinical practice and has great potential for a translational pipeline.

Abstract Objective We aimed to evaluate the prognosis and adjuvant chemotherapy (ACT) in intrahepatic cholangiocarcinoma (ICC) patients with different etiology after radical resection. Methods A total of 448 patients with ICC who underwent radical resection between 2010 and 2018 at ten Chinese tertiary hospitals were analyzed in the study. These patients were divided into conventional ICC (Con-ICC, n = 261, 58.2%), hepatitis B virus ICC (HBV-ICC, n = 102, 22.8%) and hepatolithiasis (Stone-ICC, n = 85,19.0%) subtypes according to different etiology. Propensity score matching (PSM) was conducted to mitigate the baseline differences between Con-ICC and HBV-ICC, Con-ICC and Stone-ICC, HBV-ICC and Stone-ICC subtypes. Results Univariate and multivariate analysis showed that different etiology was a prognostic factor for overall survival and relapse-free survival, and different etiology was an independent risk factor for overall survival in ICC patients, respectively (P 0.05). In Stone-ICC patients, the median overall survival was 16.0 months and 29.7 months, and the median relapse-free survival was 9.0 months and 20.0 months for non-ACT and ACT patients, respectively (P

Objective: The aim of this study was to explore the clinical value of lymph node dissection (LND) for intrahepatic cholangiocarcinoma (ICC). Methods: Clinical and pathological data were collected from 147 ICC patients who attended two tertiary centers over the past 5 years. The patients were classified into two groups: the LND group (group A) and the no-performance LND (NLND) group (group B). Clinical and pathological parameters were compared between the two groups to analyze the impact of LND on the long-term survival time of ICC patients. Results: Of the 147 patients, 54.4% (80) received LND and 42.5% (34/80) of these were found to have lymph node metastasis (LNM). LND did not increase postoperative complications (27.5%, P = 0.354), but postoperative hospital stays were longer (12.2 ± 6.3 d, P = 0.005) in group A compared with group B (20.9%, 9.5 ± 3.5 d). The 5-year survival rates of groups A and B are almost similar (21% vs 29%, P = 0.905). The overall survival rate of cN0 (diagnosis obtained by imaging) is better than pN1 (diagnosis obtained by histopathology), but lower than pN0 (all P

Sustainable production is considered as an important approach to solve the dilemma of food insecurity. Green technologies have made contributions to improving food production and reducing environmental pollution. Studying the effects of green technologies on sustainable food production has great significance. The paper started with the influence mechanism of green technology application on the green total factor productivity of grain (GTFPG). With the GTFPG, green technology efficiency change of grain (GECG) and green technical progress change of grain (GTCG) measured, threshold models were constructed to explore the nonlinear impacts of various green technologies on GTFPG and the influence paths. Results indicated that the differences of GTFPG among provinces in China were decreased mainly due to the changes of GTCG, while the regional differences of GECG remained small. The impacts of green technologies had threshold effects that depended on the ecological effects of green technologies in different application stages, and were significantly different in the major and non-major grain producing areas. Meanwhile, significant differences existed in the influence paths of green technologies. In the major grain producing areas, green technologies were more likely to improve GTFPG through the GTCG path; while in the non-major grain producing areas, the GECG path and the GTCG path were both important to improve GTFPG. The differences of green technologies’ threshold effects and influence paths in the major and non-major grain producing areas were caused by regional technology preference, resource endowment and technology compatibility. This study emphasizes that the development of green technologies should fully consider the resource endowment and economic development of different regions, as well as the applicability and adoption rate of green technologies.

Abstract Background At present, hepatectomy is still the most common and effective treatment method for intrahepatic cholangiocarcinoma (ICC) patients. However, the postoperative prognosis is poor. Therefore, the prognostic factors for these patients require further exploration. Whether microvascular invasion (MVI) plays a crucial role in the prognosis of ICC patients is still unclear. Moreover, few studies have focused on preoperative predictions of MVI in ICC patients. Methods Clinicopathological data of 704 ICC patients after curative resection were retrospectively collected from 13 hospitals. Independent risk factors were identified by the Cox or logistic proportional hazards model. In addition, the survival curves of the MVI-positive and MVI-negative groups before and after matching were analyzed. Subsequently, 341 patients from a single center (Eastern Hepatobiliary Hospital) in the above multicenter retrospective cohort were used to construct a nomogram prediction model. Then, the model was evaluated by the index of concordance (C-Index) and the calibration curve. Results After propensity score matching (PSM), Child-Pugh grade and MVI were independent risk factors for overall survival (OS) in ICC patients after curative resection. Major hepatectomy and MVI were independent risk factors for recurrence-free survival (RFS). The survival curves of OS and RFS before and after PSM in the MVI-positive groups were significantly different compared with those in the MVI-negative groups. Multivariate logistic regression results demonstrated that age, gamma-glutamyl transpeptidase (GGT), and preoperative image tumor number were independent risk factors for the occurrence of MVI. Furthermore, the prediction model in the form of a nomogram was constructed, which showed good prediction ability for both the training (C-index = 0.7622) and validation (C-index = 0.7591) groups, and the calibration curve showed good consistency with reality. Conclusion MVI is an independent risk factor for the prognosis of ICC patients after curative resection. Age, GGT, and preoperative image tumor number were independent risk factors for the occurrence of MVI in ICC patients. The prediction model constructed further showed good predictive ability in both the training and validation groups with good consistency with reality.

BackgroundSpontaneous regression of primary liver cancer is a rare event, and currently the exact pathogenesis of spontaneous tumor regression remains unclear.Case descriptionClinical information was collected from a patient with spontaneous regression of liver cancer at our center. The patient was a 41-year-old male. He was admitted to the hospital on 3 May 2019, due to aversion to fatty or greasy food, anorexia, loss of appetite, and abdominal distension. Laboratory examination results included hepatitis B surface antigen positivity, hepatitis B e antigen positivity, and hepatitis B core antibody positivity and tumor marker levels of alpha-fetoprotein 142,938.20 µg/L, abnormal prothrombin 4,599.91 mAU/ml, and carbohydrate antigen 19–9 82.05 U/ml. Upper abdominal enhanced computed tomography indicated right hepatocellular carcinoma with portal vein tumor thrombus formation. The patient declined any treatment. The tumor in the right lobe of the liver completely regressed after 1 year, and the patient is still undergoing follow-up.ConclusionsWe encountered a hepatocellular carcinoma patient who underwent spontaneous regression, but the exact pathogenesis remains unknown. Understanding the pathogenesis of spontaneous regression of hepatocellular carcinoma has the potential to contribute to the development of an effective treatment for hepatocellular carcinoma.

The effects of Fe, Cr and thermal exposure on the microstructure and mechanical properties of Al-Si alloy were investigated in this work. The results indicated that the main phases of the Al-Si-Cu-Ni-Mg-(0.6–0.9%) Fe (wt. %) alloy were α-Al, Si, Al5Cu2Mg8Si6, Al3CuNi, Al7Cu4Ni, Al2Cu, and AlFeSi at room temperature. The size of the AlSiFe phase increased with increasing the weight fraction of Fe. The shape of Fe-rich phase changed from rod-like to star-like, followed by long needle-like with Fe varying from 0.6% to 0.9%. The mechanical properties of the studied alloys at elevated temperatures increased with Fe. The ultimate tensile strength of the three alloys at 350 °C was 111.2 MPa, 124 MPa, and 128.7 MPa, respectively. In addition, the ductility and strength of the studied alloys at room temperature decreased with increasing the Fe, due to the large size of the hard and brittle Fe-rich phase strictly cleaved the aluminum matrix. After thermal exposure, the properties of the alloy at room temperature and elevated temperature decreased obviously at the beginning of 0.5~8 h, and then tend to be stabilized during thermal exposure at 350 °C for approximately 32~64 h. Fe-rich was a thermal stable phase at 350 °C.

Abstract Background The objective of this study was to investigate the survival outcomes of surgical margin width in intrahepatic cholangiocarcinoma (ICC). Methods Between November 2011 and August 2017, patients who underwent hepatectomy for ICC were collected from 13 major hepatopancreatobiliary centers in China. The survival outcomes for patients who underwent wide margin hepatectomy (WMH) were compared with those who underwent narrow margin hepatectomy (NMH) using the 1:1 propensity score matching (PSM). Results Among 478 included patients, 195 (40.8%) underwent WMH whereas 283 (59.2%) underwent NMH. PSM yielded 79 matched patients with similar baseline characteristics. Patients underwent WMH had a significant better OS and DFS compared with those underwent NMH (before PSM: median OS 27 vs 17 months, P

BackgroundThe influence of different postoperative recurrence times on the efficacy of adjuvant chemotherapy (ACT) for intrahepatic cholangiocarcinoma (ICC) remains unclear. This study aimed to investigate the independent risk factors and establish a nomogram prediction model of early recurrence (recurrence within 1 year) to screen patients with ICC for ACT.MethodsData from 310 ICC patients who underwent radical resection between 2010 and 2018 at eight Chinese tertiary hospitals were used to analyze the risk factors and establish a nomogram model to predict early recurrence. External validation was conducted on 134 patients at the other two Chinese tertiary hospitals. Overall survival (OS) and relapse-free survival (RFS) were estimated by the Kaplan–Meier method. Multivariate analysis was conducted to identify independent risk factors for prognosis. A logistic regression model was used to screen independent risk variables for early recurrence. A nomogram model was established based on the above independent risk variables to predict early recurrence.ResultsACT was a prognostic factor and an independent affecting factor for OS and RFS of patients with ICC after radical resection (p 0.05). While the median OS of ICC patients with non-ACT and ACT was 41.0 and 84.0 months, the median RFS was 20.0 and 45.0 months for the late recurrence group, respectively (p

An online model is proposed for predicting deformation resistance in the strip tandem cold rolling by combining the back propagation neural network optimized by the mind evolutionary algorithm (MEA-BP) and the deformation resistance analytical model. The real-time collection of hot and cold rolling process data is achieved by constructing a “hot and cold rolling” cross-process data platform. Based on this, a dataset including historical production data of hot and cold rolling is established to train and test the model. The application result of the proposed model shows that the deformation resistance prediction error can be reduced from ±12% to ±5% compared with the traditional analytical model, which demonstrates the model established in this work can effectively improve the prediction accuracy of the deformation resistance in the strip tandem cold rolling.

Introduction Pancreatic cancer is one of the deadliest cancers and pancreaticoduodenectomy (PD) is recommended as the optimal operation for resectable pancreatic head cancer. Minimally invasive surgery, which initially emerged as hybrid-laparoscopy and recently developed into total laparoscopy surgery, has been widely used for various abdominal surgeries. However, controversy persists regarding whether laparoscopic PD (LPD) is inferior to open PD (OPD) for resectable pancreatic ductal adenocarcinoma (PDAC) treatment. Further studies, especially randomised clinical trials, are warranted to compare these two surgical techniques.Methods and analysis The TJDBPS07 study is designed as a prospective, randomised controlled, parallel-group, open-label, multicentre noninferiority study. All participating pancreatic surgical centres comprise specialists who have performed no less than 104 LPDs and OPDs, respectively. A total of 200 strictly selected PD candidates diagnosed with PDAC will be randomised to receive LPD or OPD. The primary outcome is the 5-year overall survival rate, whereas the secondary outcomes include overall survival, disease-free survival, 90-day mortality, complication rate, comprehensive complication index, length of stay and intraoperative indicators. We hypothesise that LPD is not inferior to OPD for the treatment of resectable PDAC. The enrolment schedule is estimated to be 2 years and follow-up for each patient will be 5 years.Ethics and dissemination This study received approval from the Tongji Hospital Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, and monitor from an independent third-party organisation. Results of this trial will be presented in international meetings and published in a peer-reviewed journal.Trial registration number NCT03785743.

Background and AimsMost microvascular invasion (MVI)-predicting models have not considered MVI classification, and thus do not reflect true MVI effects on prognosis of patients with hepatocellular carcinoma (HCC). We aimed to develop a novel MVI-predicting model focused on MVI classification, hoping to provide useful information for clinical treatment strategy decision-making.MethodsA retrospective study was conducted with data from two Chinese medical centers for 800 consecutive patients with HCC (derivation cohort) and 250 matched patients (external validation cohort). MVI-associated variables were identified by ordinal logistic regression. Predictive models were constructed based on multivariate analysis results and validated internally and externally. The models’ discriminative ability and calibration ability were examined.ResultsFour factors associated independently with MVI: tumor diameter, tumor number, serum lactate dehydrogenase (LDH) ≥ 176.58 U/L, and γ-glutamyl transpeptidase (γ-GGT). Area under the curve (AUC)s for our M2, M1, and M0 nomograms were 0.864, 0.648, and 0.782. Internal validation of all three models was confirmed with AUC analyses in D-sets (development datasets) and V-sets (validation datasets) and C-indices for each cohort. GiViTI calibration belt plots and Hosmer-Lemeshow (HL) chi-squared calibration values demonstrated good consistency between observed frequencies and predicted probabilities for the M2 and M0 nomograms. Although the M1 nomogram was well calibrated, its discrimination was poor.ConclusionWe developed and validated MVI prediction models in patients with HCC that differentiate MVI classification and may provide useful guidance for treatment planning.

ABSTRACT Purpose Various surgical options are available for large proximal ureteral stones, such as extracorporeal shock wave lithotripsy (ESWL), ureteroscopic lithotripsy (URSL), percutaneous nephrolithotomy (PCNL) and laparoscopic ureterolithotomy (LU). However, the best option remains controversial. Therefore, we conducted a network meta-analysis comparing various surgical treatments for proximal ureteral stones ≥10mm to address current research deficiencies. Materials and methods We searched PubMed, Ovid, Scopus (up to June 2019), as well as citation lists to identify eligible comparative studies. All clinical studies including patients comparing surgical treatments for proximal ureteral stones ≥10mm were included. A standard network meta-analysis was performed with Stata SE 14 (Stata Corp, College Station, TX, USA) software to generate comparative statistics. The quality was assessed with level of evidence according to the Oxford Centre for Evidence-based Medicine and risk of bias with the Cochrane Collaboration’s Review Manager (RevMan) 5.3 software. Results A total of 25 studies including 2.888 patients were included in this network meta-analysis. Network meta-analyses indicated that LU and PCNL had better stone-free rates and auxiliary procedures. PCNL could result in major complications and severe bleeding. In initial stone-free rate, final stone-free rate, and auxiliary procedures results, SUCRA ranking was: LU> PCNL> URSL> ESWL. In Clavien Dindo score ≥3 complications, SUCRA ranking was: LU> ESWL> URSL> PCNL. In fever, SUCRA ranking was: ESWL> LU> URSL> PCNL. In transfusion, SUCRA ranking was: LU> URSL> ESWL> PCNL. In Cluster analysis, LU had the highest advantages and acceptable side effects. Considering the traumatic nature of PCNL, it should not be an option over URSL. ESWL had the lowest advantages. Conclusions LU have the potential to be considered as the first treatment choice of proximal ureteral stone ≥10mm.

Abstract Background and Aims The prognosis of intrahepatic cholangiocarcinoma (ICC) after radical resection is far from satisfactory; however, the clinical value of adjuvant therapy (AT) remains controversial. This multicenter study aimed to evaluate the clinical value of AT and identify potential patients who would be benefited from AT. Methods Data from ICC patients who underwent radical resection were retrospectively collected from 12 hepatobiliary centers in China between December 2012 and December 2015. Patients were divided into AT and non‐AT groups based on whether AT was administered or not. Overall survival (OS) and disease‐free survival (DFS) were analyzed using the Kaplan‐Meier method before and after 1:2 propensity score matching (PSM). Subgroup analyses were conducted based on the established staging systems. Results A total of 412 patients were enrolled in this study, and 77 patients (18.9%) received AT, including 32 (7.8%) patients who received transarterial chemoembolization (TACE), 21 (5.1%) patients who received chemotherapy, 10 (2.4%) patients who received radiotherapy, and 14 (3.4%) patients who received adjuvant chemoradiotherapy. The median OS and DFS were both longer in the AT group than in the non‐AT group (43.0 months vs 21.0 months, P = .015; 16.0 months vs 11.0 months, P = .045, respectively), and the advantage of AT was confirmed for both the OS and DFS (P = .023; P = .046, respectively) after 1:2 PSM. Furthermore, based on the established nomogram, only “middle‐risk” patients receiving AT cherished a longer median OS (43.0 months vs 20.0 months, P = .033). In subgroup analyses that were stratified by different AT strategies, patients receiving postoperative chemotherapy had a longer median OS (37.0 months vs 21.0 months, P = .039), while patients receiving postoperative TACE had a longer median DFS (50.0 months vs 11.0 months, P = .007). Conclusion With the current data, we conclude that AT benefits ICC patients following radical resection, especially those “middle‐risk” patients, as evaluated by the established nomogram. However, exactly which patients are the most suitable for AT requires further study and validation.

BackgroundThe preoperative nutritional status and the immunological status have been reported to be independent prognostic factors of patients with intrahepatic cholangiocarcinoma (ICC). This study aimed to investigate whether prognostic nutritional index (PNI) + albumin–bilirubin (ALBI) could be a better predictor than PNI and ALBI alone in patients with ICC after radical resection.MethodsThe prognostic prediction evaluation of the PNI, ALBI, and the PNI+ALBI grade was performed in 373 patients with ICC who underwent radical resection between 2010 and 2018 at six Chinese tertiary hospitals, and external validation was conducted in 162 patients at four other Chinese tertiary hospitals. Overall survival (OS) and relapse-free survival (RFS) were estimated using the Kaplan–Meier method. Multivariate analysis was conducted to identify independent prognostic factors. A time-dependent receiver operating characteristic (ROC) curve and a nomogram prediction model were further constructed to assess the predictive ability of PNI, ALBI, and the PNI+ALBI grade. The C-index and a calibration plot were used to assess the performance of the nomogram models.ResultsUnivariate analysis showed that PNI, ALBI, and the PNI+ALBI grade were prognostic factors for the OS and RFS of patients with ICC after radical resection in the training and testing sets (p < 0.001). Multivariate analysis showed that the PNI+ALBI grade was an independent risk factor for OS and RFS in the training and testing sets (p < 0.001). Analysis of the relationship between the PNI+ALBI grade and clinicopathological characteristics showed that the PNI+ALBI grade correlated with obstructive jaundice, alpha-fetoprotein (AFP), cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA125), PNI, ALBI, Child–Pugh grade, type of resection, tumor size, major vascular invasion, microvascular invasion, T stage, and N stage (p < 0.05). The time-dependent ROC curves showed that the PNI+ALBI grade had better prognostic predictive ability than the PNI, ALBI, and the Child–Pugh grade in the training and testing sets.ConclusionPreoperative PNI+ALBI grade is an effective and practical predictor for the OS and RFS of patients with ICC after radical resection.

In order to solve the problem of low accuracy of small target detection in traditional target detection algorithms, the YOLOX algorithm combined with Convolutional Block Attention Module (CBAM) is proposed. The algorithm first uses CBAM on the shallow feature map to better focus on small target information, and the Focal loss function is used to regress the confidence of the target to overcome the positive and negative sample imbalance problem of the one-stage target detection algorithm. Finally, the Soft Non-Maximum Suppression (SNMS) algorithm is used for post-processing to solve the problem of missed detection in close range ship target detection. The experimental results show that the average accuracy of the proposed CBAM-YOLOX network target detection is improved by 4.01% and the recall rate is improved by 8.81% compared with the traditional YOLOX network, which verifies the effectiveness of the proposed algorithm.

Laser ultrasound signal echoes are easily drowned out by the surrounding environmental noise in industrial field applications, and it is worthwhile to study methods of retaining the weak ultrasound signal during signal processing. To address this problem, this paper proposes to adopt the parameters optimized by the whale optimization algorithm to the variational mode decomposition (VMD) of laser ultrasound signals. The optimized parameters can avoid the frequency mixing and incomplete noise separation caused by the choice of artificial VMD parameters. The Hausdorff distance is applied in the process of reconstructing the signal to help accurately select the relevant modes and improve the signal-to-noise ratio. Simulation and experimental results show that the proposed method is feasible and effective compared with the other three available denoising methods.

Precision interventional brachytherapy is a radiotherapy technique that combines radiation therapy medicine with computer network technology, physics, etc. It can solve the limitations of conventional brachytherapy. Radioactive drugs and their carriers change with each passing day, and major research institutions and enterprises worldwide have conducted extensive research on them. In addition, the capabilities of interventional robotic systems are also rapidly developing to meet clinical needs for the precise delivery of radiopharmaceuticals in interventional radiotherapy. This study reviews the main radiopharmaceuticals, drug carriers, dispensing and fixation technologies, and interventional robotic precision delivery systems used in precision brachytherapy of malignant tumors. We then discuss the current needs in the field and future development prospects in high-precision interventional brachytherapy.

Flatness is a vital quality index that determines the dimensional accuracy of the cold-rolled strip. This paper designs a local shape wave extraction algorithm and a fuzzy classification algorithm for overall flatness defect classification based on cosine distance. By introducing the small displacement buckling theory of thin plates, the plate stress buckling model of overall and local shape waves is studied, and the critical buckling elongation difference of the overall shape and the local shape under the given conditions are obtained. Finally, using the multi-objective decision-making evaluation method, a comprehensive evaluation model of the flatness quality is established. The model is applied to the actual cold rolling production. The on-site flatness data are used to verify the flatness quality determination model both locally and overall. The results show that the model can accurately identify the local and overall flatness defects of cold-rolled strips, realizes the accurate identification and evaluation of the cold-rolled flatness quality, and provides strong support for the optimization of rolling process parameters and the improvement of the quality of thin strip products.

Due to its extreme service conditions, low-temperature pressure piping often needs post-welding stress measurement and control. Aiming at the phenomenon of local stress concentration in welded 316L pipes, this study used ultrasound to regulate the stress in the welded area at different times during and after the multi-layer welding of the pipeline butt joint for different time lengths. Mechanical properties such as tensile strength and hardness were tested for each comparison group, and the microcrystalline phases of the weld and its surrounding microstructure were analyzed. The transverse and longitudinal surface residual stresses of each comparison group were measured. The influence of high-energy ultrasound on the surface temperature field during and after welding was analyzed. The experimental results show that ultrasonic wave regulation can speed up heat exchange and radiation in the weld zone (WZ), refine the grains in the WZ, heat-affected zone (HAZ) and fusion zone (FZ) to some extent and reduce and homogenize residual stress to a certain degree. In the 120 mm area of the weld center, the residual stress measured after the mid-welding regulation was smaller than that of any other comparison group. This regulation result was the best, followed by that of hot regulation and finally that of offline regulation. The tensile strengths obtained by the mid-welding regulation and post-welding hot regulation of this group were the best, increasing by 17.2% and 24.3%, respectively, compared with the untreated groups.

Purpose: This review article aims to consolidate information regarding existing and emerging implanted devices used in patients undergoing radiation therapy and to categorize levels of attention needed for each device, including which devices require monitoring throughout treatment. Methods and Materials: Based on the collective information from scholar searches, manufacturers’ technical reports, and institutional experiences in the past years, commonly present devices in patients with cancer are compiled. This work summarizes cardiac pacemaker, implanted cardiac defibrillator, hepatic pump, intrathecal pain pump, neurostimulator, shunt, loop recorder, and mediport. Three different classifications of implanted devices can be made based on the potential effect of radiation: life-dependent, nonlife-dependent but with adverse effects if overdosed, and devices without electronic circuits. Implanted devices that contain electronic circuits that would be life-dependent or have adverse effects if overdosed, include cardiac pacemakers, implanted cardiac defibrillators, programmable hepatic pumps, pain pumps, neurostimulators, and loop recorders. Results: Dose exposure to these devices need to be calculated or measured in vivo, especially for cardiac implanted devices, and they should be minimized to assure continued healthy functioning. Treatment planning techniques should be chosen to reduce entry, exit and internal scatter dose. Lower energy photon beams should be used to decrease potential neutron contamination. Implanted devices without electronic circuits are less of a concern. If a patient is life-dependent on the implanted device, it is not recommended to treat the patient with proton therapy. Conclusions: This study reviewed the management of patients with commonly seen implanted devices and summarized a workflow for identifying and planning when a patient has implanted devices. Classifications of implanted devices could help clinicians make proper decisions in regard to patients with specific implanted devices. Lastly, the management of such devices in the era of the pandemic is also discussed in this review article.

The food supply chain operates in a complex and dynamic external environment, and the external uncertainties from natural and socio-economic environment pose great challenges to the development of the food industry. In particular, the COVID-19 pandemic and Russia–Ukraine conflict have further exacerbated the vulnerability of the global food supply chain. Analyzing the dynamic impacts of external uncertainties on the stability of food supply chain is central to guaranteeing the sustainable security of food supply. Based on the division of food supply chain and the classification of external uncertainties, the TVP-FAVAR-SV model was constructed to explore the dynamic impacts of external uncertainties on food supply chain. It was found that the impacts of external uncertainty elements were significantly different, the combination of different external uncertainty elements aggravated or reduced the risks of food supply chain. And some uncertainty elements had both positive and negative impacts in the whole sample period, as the magnitude and direction of the impacts of various uncertainties in different periods had time-varying characteristics.

BackgroundThe clinical value of lymph-node dissection (LND) for intrahepatic carcinoma (ICC) patients with clinically negative lymph node metastasis (LNM) remains unclear; hence we conducted a multi-center study to explore it.MethodsPatients who were diagnosed ICC with clinically negative LNM and underwent hepatectomy with or without LND from December 2012 to December 2015 were retrospectively collected from 12 hepatobiliary centers in China. Overall survival (OS) was analyzed using the Kaplan–Meier method, and then subgroup analysis was conducted stratified by variables related to the prognosis.ResultsA total of 380 patients were eligible including 106 (27.9%) in the LND group and 274 (72.1%) in the non-LND group. Median OS in the LND group was slightly longer than that in the non-LND group (24.0 vs. 18.0 months, P = 0.30), but a significant difference was observed between the two groups (24.0 vs. 14.0 months, P = 0.02) after a well-designed 1:1 propensity score matching without increased severe complications. And, LND was identified to be one of the independent risk factors of OS (HR = 0.66, 95%CI = 0.46–0.95, P = 0.025). Subgroup analysis in the matched cohort showed that patients could benefit more from LND if they were male, age 5 cm, single tumor, mass-forming, no satellite, no MVI, and no perineural invasion (all P < 0.05). Furthermore, only patients with pathologically confirmed positive LNM were found to benefit from postoperative adjuvant therapy (P < 0.001).ConclusionWith the current data, we concluded that LND would benefit the selected ICC patients with clinically negative LNM and might guide the postoperative management.

This paper investigates a modified modeling of networked control systems (NCSs) with programmable logic controller (PLC). First, the controller-to-actuator and sensor-to-controller network-induced delays are investigated by a modeling tactics based on hierarchical coloured petri net (HCPN) in a structure-conserving way. Comparing with the recent result, the signal transmission delay is set in a random interval instead of a fixed mode; moreover, the data packet drop out and disorder are also taken into consideration. Second, delays captured form CPN tools are analyzed with a strategy based on Baum–Welch algorithm and statistics science. Besides, time delays are modeled as a Markov chain and the transition probabilities is calculated using the consequent from the previous operation. Finally, a comparison verification illustrates the equivalence property between proposed models.

Accumulating evidence indicates an unexpected role of aberrant splicing in hepatocellular carcinoma (HCC) that has been seriously neglected in previous studies. There is a need for a detailed analysis of alternative splicing (AS) and its underlying biological and clinical relevance in HCC. In this study, clinical information and corresponding RNA sequencing data of HCC patients were obtained from The Cancer Genome Atlas. Percent spliced in (PSI) values and transcriptional splicing patterns of genes were determined from the original RNA sequencing data using SpliceSeq. Then, based on the PSI values of AS events in different patients, a series of bioinformatics methods was used to identify differentially expressed AS events (DEAS), determine potential regulatory relationships, and investigate the correlation between DEAS and the patients’ clinicopathological features. Finally, 25,934 AS events originating from 8,795 genes were screened with high reliability; 263 of these AS events were identified as DEAS. The parent genes of these DEAS formed an intricate network with roles in the regulation of cancer-related pathway and liver metabolism. In HCC, 36 splicing factors were involved in the dysregulation of part DEAS, 100 DEAS events were correlated with overall survival, and 71 DEAS events were correlated with disease-free survival. Stratifying HCC patients according to DEAS resulted in four clusters with different survival patterns. Significant variations in AS occurred during HCC initiation and maintenance; these are likely to be vital both for biological processes and in prognosis. The HCC-related AS events identified here and the splicing networks constructed will be valuable in deciphering the underlying role of AS in HCC.

Power seats (i.e., electrically adjustable seats that can be designed to move in several ways) have become increasingly common in airplanes, vehicles, and offices. Many studies have investigated the effects of seat attitude parameters, for example, the inclined angles of a backrest, on discomfort during the adjustment process. However, few studies have considered discomfort under different speeds during the adjustment process. In this study, we investigated discomfort with three speeds (i.e., “fast”, “median”, and “slow” corresponding to three durations of 15, 20, and 25 s, respectively) and two adjustments of a power seat, i.e., incline angle adjustment of the backrest and fore-and-aft position adjustment of the seat pan. We also investigated the effects of different physiological parameters on subjects’ discomfort. Twenty-four subjects (12 males and 12 females) completed a questionnaire to indicate their adjustment condition preferences, to rate their overall discomfort during the adjustment processes on a category-ratio scale, and to rate their local body discomfort. The majority of subjects preferred the fast speed adjustment condition and the trend was that a lower backrest adjustment speed increased discomfort during the process. The dominant local discomfort was in the upper and lower back regions during the backrest adjustment, whereas there was no obvious dominant local discomfort during the seat pan adjustment. The physiological parameters also had significant correlations with discomfort in some adjustment movements, for example, the discomfort was negatively correlated with height during the backrest adjustment.