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Abstract Background Lenvatinib is widely used in treatment of unresectable hepatocellular carcinoma (uHCC), but the benefit of its combination with immunotherapy needs to be verified. This study evaluated the efficacy and safety of tislelizumab plus lenvatinib in systemic treatment-naïve patients with uHCC. Methods In this multicenter, single-arm, phase 2 study, systemic treatment-naïve patients with uHCC received tislelizumab 200 mg every three weeks plus lenvatinib (bodyweight ≥ 60 kg: 12 mg; 6 responders were needed in stage 1 (n = 30) to continue the study, and ≥ 18 responders were needed by the end of stage 2 (n = 60) to demonstrate statistical superiority to a historical control of lenvatinib monotherapy. Results Sixty-four patients were enrolled. No DLTs were reported. The study achieved statistical superiority (p = 0.0003) with 23 responders assessed by IRC per RECIST v1.1 in the first 60 patients of the efficacy evaluable analysis set (n = 62). After a median follow-up of 15.7 months, confirmed ORR and disease control rate were 38.7% (24/62, 95% confidence interval [CI], 26.6–51.9) and 90.3% (56/62, 95% CI, 80.1–96.4), respectively. Median progression-free survival was 8.2 months (95% CI, 6.8–not evaluable). Overall survival rate at 12 months was 88.6% (95% CI, 77.7–94.4). Grade ≥ 3 treatment-related adverse events occurred in 18 (28.1%) patients. Conclusions Tislelizumab plus lenvatinib demonstrated promising antitumor activity with favourable tolerability as first-line therapy for patients with uHCC. Trial registration ClinicalTrials.gov (NCT 04401800).

Abstract Immune checkpoint blockade (ICB) has shown considerable promise for treating various malignancies, but only a subset of cancer patients benefit from immune checkpoint inhibitor therapy because of immune evasion and immune-related adverse events (irAEs). The mechanisms underlying how tumor cells regulate immune cell response remain largely unknown. Here we show that hexokinase domain component 1 (HKDC1) promotes tumor immune evasion in a CD8+ T cell-dependent manner by activating STAT1/PD-L1 in tumor cells. Mechanistically, HKDC1 binds to and presents cytosolic STAT1 to IFNGR1 on the plasma membrane following IFNγ-stimulation by associating with cytoskeleton protein ACTA2, resulting in STAT1 phosphorylation and nuclear translocation. HKDC1 inhibition in combination with anti-PD-1/PD-L1 enhances in vivo T cell antitumor response in liver cancer models in male mice. Clinical sample analysis indicates a correlation among HKDC1 expression, STAT1 phosphorylation, and survival in patients with hepatocellular carcinoma treated with atezolizumab (anti-PD-L1). These findings reveal a role for HKDC1 in regulating immune evasion by coupling cytoskeleton with STAT1 activation, providing a potential combination strategy to enhance antitumor immune responses.

Air-assisted sprayers are widely used in orchards due to their efficiency in enhancing droplet penetration and deposition. These sprayers disperse droplets through a high-velocity airflow, which agitates the leaves and aids in canopy penetration. This study involved controlled experiments to simulate leaf movement during field spraying, with a focus on the dynamics of peach tree leaves (Prunus persica) in varying wind fields. An experimental setup consisting of a wind-conveying system, a measurement system, and a fixed system was designed. The moving speeds of the wind field (0.75 m/s, 0.5 m/s, and 1.0 m/s) and wind velocities (ranging from 2 m/s to 8 m/s) were varied. Key parameters, including leaf tip displacement, angular velocity, and twisting amplitude, were measured using high-speed cameras and motion analysis software. The results indicate that, at a constant wind velocity, increasing the wind field’s moving speed resulted in a reduced range of motion, decelerated angular velocity, and decreased twisting amplitude of the leaves. Notably, at a wind field speed of 8 m/s and a moving speed of 1.0 m/s, the twisting duration of the leaves was only 67% of that observed at a moving speed of 0.5 m/s. These findings suggest that wind speed and field motion characteristics play a crucial role in leaf dynamics, informing the design of air-assisted spraying systems.

The fruit industry is a significant economic sector in China, with modern orchards gradually transitioning to trellis orchards. For mechanized orchard operations, automatic vehicle navigation is essential. However, in trellis orchards, the shading from trees results in low average light intensity and large variations in lighting, posing challenges for path navigation. To address this, a path navigation algorithm for trellis orchards is proposed based on the UNet-CBAM model. The network structures of UNet, FCN, and SegNet are compared to identify and select the optimal structure for further improvement. Among the three attention mechanisms of channel attention, spatial attention, and combined attention, the most effective mechanism is identified. The optimal attention mechanism is incorporated into the optimized network to enhance the model’s ability to detect path edges and improve detection performance. To validate the effectiveness and generalizability of the model, a total of 400 images were collected under varying lighting intensities. The experimental results show that this method achieves an accuracy of 97.63%, a recall of 93.94%, and an Intersection over Union (IoU) of 92.19%. These results significantly enhance path recognition accuracy in trellis orchards, particularly under low light under conditions. Compared to the FCN and SegNet algorithms, this method provides higher detection accuracy and offers a new theoretical foundation and research approach for path recognition in low-light environments.

This article reports the design and experiment of a novel air-assisted nozzle for pesticide application in orchard. A novel air-assisted nozzle was designed based on the transverse jet atomization pattern. This article conducted the performance and deposition experiments and established the mathematical model of volume median diameter (D50) and liquid flow rate with the nozzle design parameters. The D50 of this air-assisted nozzle ranged from 52.45 μm to 113.67 μm, and the liquid flow rate ranged from 142.6 ml/min to 1,607.8 ml/min within the designed conditions. These performances meet the low-volume and ultra-low-volume pesticide application in orchard. The droplet deposition experiment results demonstrated that the droplet coverage distribution in different layers and columns is relatively uniform, and the predicted value of spray penetration (SP) numbers SPiA, SPiB, and SPiC (i = 1, 2, and 3) are approximately 70%, 60%, and 70%, respectively. The droplet deposits on the foliage of the canopy (inside and outside) uniformly bring benefit for plant protection and pesticide saving. Compared with the traditional air-assisted nozzle that adopts a coaxial flow atomization pattern, the atomization efficiency of this air-assisted nozzle is higher. Moreover, the nozzle air pressure and liquid flow rate are considerably lower and greater than the traditional air-assisted nozzle, and these results proved that this air-assisted nozzle has great potential in orchard pesticide application. The relationship between the D50 and nozzle liquid pressure of this air-assisted nozzle differs from that of traditional air-assisted nozzles due to the atomization pattern and process. While this article provides an explanation for this relationship, further study about the atomization process and mechanism is needed so as to improve the performance.

Traditional methods of weed control during field management often result in herbicide waste. Precision herbicide application is crucial in agricultural production. This study presents a monodisperse droplet-generation system designed for precision herbicide application, capable of generating monodisperse droplets induced by an electric field. Droplet-generation experiments were conducted to investigate the effects of capillary tube outlet shape, liquid flow rate, and capillary tube size on the generation of charged droplets. A droplet diameter prediction model was established based on the system parameters. Experimental results indicated that as the applied voltage increased, the droplet diameter decreased, and the droplet-generation patterns transitioned sequentially from dripping, micro-dripping, to unstable dripping modes. In a weak electric field, capillaries with beveled outlets produced smaller droplets with more stable diameter distributions compared to those with blunt outlets. In a strong electric field, the smallest droplet diameter from blunt capillaries was 138.2 μm, whereas from beveled capillaries it was 198.7 μm. Within the design parameter range, droplet diameter was basically positively correlated with liquid flow rate and capillary tube size. By controlling the applied voltage, liquid flow rate, and capillary tube size, stable droplet generation could be achieved within a diameter range of 198.7–2520.8 μm, and the coefficient of variation of droplet diameter under the same working conditions was generally less than 6%. The monodisperse droplet-generation system developed in this study can effectively reduce herbicide usage and improve application efficiency.

Comprehensive growth index (CGI) more accurately reflects crop growth conditions than single indicators, which is crucial for precision irrigation, fertilization, and yield prediction. However, many current studies overlook the relationships between different growth parameters and their varying contributions to yield, leading to overlapping information and lower accuracy in monitoring crop growth. Therefore, this study focuses on winter wheat and constructs a comprehensive growth monitoring index (CGIac), based on adaptive weight allocation of growth parameters’ contribution to yield, using data such as leaf area index (LAI), soil plant analysis development (SPAD) values, plant height (PH), biomass (BM), and plant water content (PWC). Using UAV data on vegetation indices, feature selection was performed using the Elastic Net. The growth inversion model was then constructed using machine learning methods, including linear regression (LR), random forest (RF), gradient boosting (GB), and support vector regression (SVR). Based on the optimal growth inversion model for winter wheat, spatial distribution of wheat growth in the study area is obtained. The findings demonstrated that CGIac outperforms CGIav (constructed using equal weighting) and CGIcv (built using the coefficient of variation) in yield correlation and prediction accuracy. Specifically, the yield correlation of CGIac improved by up to 0.76 compared to individual indices, while yield prediction accuracy increased by up to 23.14%. Among the evaluated models, the RF model achieved the best performance, with a coefficient of determination (R2) of 0.895 and a root mean square error (RMSE) of 0.0058. A comparison with wheat orthophotos from the same period confirmed that the inversion results were highly consistent with actual growth conditions in the study area. The proposed method significantly improved the accuracy and applicability of winter wheat growth monitoring, overcoming the limitations of single parameters in growth prediction. Additionally, it provided new technological support and innovative solutions for regional crop monitoring and precision farming operations.

The farmland system in the global terrestrial ecosystem has dual attributes as both a carbon source and a carbon sink, playing a crucial role in controlling carbon emissions and mitigating global warming. Using carbon source and sink accounting of farmland ecosystems, we applied methods such as standard deviation ellipse, Tapio decoupling theory, and Markov chain to analyze the spatiotemporal changes, response mechanisms, and evolutionary trends of regional carbon effects. The results indicated that from 2011 to 2021, the farmland ecosystem in the middle and lower reaches of the Yangtze River consistently acted as a carbon sink. However, the net carbon sink showed slight fluctuations and significant spatial differences. The migration range of the net carbon sink center in the farmland ecosystem of the middle and lower reaches of the Yangtze River was relatively small, ranging from 115.52 to 115.77° E and 30.14 to 30.27° N. The decomposition of the Tapio decoupling index between the net carbon sink of the farmland ecosystem and agricultural output value showed the order of effects on their coupling relationship as follows: agricultural mechanization level > agricultural mechanization efficiency > agricultural output value > planting scale. The probability of maintaining the original state of net carbon sink in various cities in the middle and lower reaches of the Yangtze River (over 77%) was much higher than the probability of transfer, making it difficult to achieve a leapfrog growth in net carbon sink. The net carbon sink at the city scale exhibits the Matthew effect and spatial spillover effect. The above research results clarify the spatiotemporal changes in carbon effects in agricultural production at multiple levels, including city, province, and region. They also provide a theoretical basis for formulating differentiated regional emission reduction and sink enhancement strategies in the middle and lower reaches of the Yangtze River, promoting the rapid development of low-carbon agriculture in China.

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. Most HCC patients have the complications of chronic liver disease and need overall consideration and whole-course management, including diagnosis, treatment, and follow-up. To develop a reasonable, long-term, and complete management plan, multiple factors need to be considered, including the patient’s general condition, basic liver diseases, tumor stage, tumor biological characteristics, treatment requirements, and economic cost. Summary: To better guide the whole-course management of HCC patients, the Chinese Association of Liver Cancer and the Chinese Medical Doctor Association has gathered multidisciplinary experts and scholars in relevant fields to formulate the “Chinese Expert Consensus on The Whole-Course Management of Hepatocellular Carcinoma (2023).” Key Messages: This expert consensus, based on the current clinical evidence and experience, proposes surgical and nonsurgical HCC management pathways and involves 18 recommendations, including perioperative treatment, systematic treatment combined with local treatment, conversion treatment, special population management, symptomatic support treatment, and follow-up management.

Soybean plants form symbiotic nitrogen-fixing nodules with specific rhizobia bacteria. The root hair is the initial infection site for the symbiotic process before the nodules. Since roots and nodules grow in soil and are hard to perceive, little knowledge is available on the process of soybean root hair deformation and nodule development over time. In this study, adaptive microrhizotrons were used to observe root hairs and to investigate detailed root hair deformation and nodule formation subjected to different rhizobia densities. The result showed that the root hair curling angle increased with the increase of rhizobia density. The largest curling angle reached 268° on the 8th day after inoculation. Root hairs were not always straight, even in the uninfected group with a relatively small angle (

Electrostatic spraying technology can improve the efficiency of pesticide deposition on the surface of leaves and reduce the environmental pollution caused by pesticide drift, which has an important prospect in agricultural pesticide application. To improve the deposition and penetration of droplets in the crop canopy, we designed and optimized an air-assisted electrostatic nozzle and conducted the spraying performance experiment. Parameters, such as charge-to-mass ratio (CMR) and particle size, were tested and analyzed to obtain the suitable operating parameters of nozzle. The results proved that the improved air-assisted electrostatic nozzle has good atomization and chargeability. There is a good charging effect with a charging voltage of 3,000–5,000 V, the CMR increased 127.8% from 0.86 to 1.97 mC/kg as the charge voltage increases from 1,000 to 4,000 V, at an air pressure of 1.0 bar and liquid flow rate of 200 ml/min. Furthermore, we designed a multi-factor orthogonal experiment, which was conducted using a four-factor, three-level design to investigate the effects of operational parameters and canopy characteristics on droplet deposition and penetration. Analysis of variance (ANOVA) and F-test were performed on the experiment results. The results showed that the factor effect on droplet penetration, in descending order, was as follows: spray distance, leaf area index, air pressure, and air pressure × spray distance. The factor effect on abaxial leaf deposition, in descending order, was as follows: air pressure, spray distance, air pressure × charge voltage, spray distance × charge voltage, and charge voltage. For optimal droplet penetration and abaxial leaf deposition, option A3B1D2 (air pressure 1.5 bar, spray distance 0.2 m, charge voltage 2,500 V) is recommend. The spray nozzle atomization performance and deposition regulation were studied by experimental methods to determine the optimal values of operating parameters to provide a reference for electrostatic spray system development.

This paper presents the design of an intra-row obstacle avoidance shovel-type weeding machine. Theoretical analysis of intra-row weeding components guided the determination of the structures and parameters for key parts, including the signal acquisition mechanism, automatic obstacle avoidance mechanism, and weeding shovel. Furthermore, a hydraulic system was designed to support these functions. The design aims to optimize intra-row weeding operations, reduce labor costs, enhance weed control effectiveness, and prevent collisions between weeding equipment and grapevines. Through the construction of a mathematical model, the analysis determined the necessary minimum return speed of the hydraulic cylinder for the intra-row weeding shovel to avoid grapevines. We also established a reasonable range for the extension speed of the hydraulic cylinder to minimize areas missed during weeding. Further analysis showed that using the minimum return speed of the hydraulic cylinder effectively reduced missed weeding areas. A virtual prototype model of the weeding machine was created in ADAMS. Using the coverage rate of weeding operation as the evaluation index, single-factor simulation tests determined that the extension speed of the piston rod in the obstacle avoidance hydraulic cylinder and the forward speed of the weeding machine are the main influencing factors. The preset threshold of the control system, which triggered the automatic obstacle avoidance mechanism when the obstacle avoidance rod reached a specific angle (the “Angle Threshold”), was identified as a secondary influencing factor. Other factors were considered irrelevant. Hydraulic cylinder extension speed, weeding machine forward speed, and angle threshold were chosen as the influencing factors. Following the principles of a Box–Behnken experimental design, a quadratic regression combination experiment was designed using a three-factor, three-level response surface analysis method. The evaluation criterion focused on the coverage rate of weeding operation. A regression model was developed to determine the coverage rate of the weeding operation, identifying the optimal parameters as follows: obstacle avoidance hydraulic cylinder extension speed of 120 mm/s, forward speed of the weeding machine at 0.6 m/s, and an angle threshold of 18°. The optimized coverage rate of the weeding operation achieved 86.1%. This study serves as a reference for further optimization of intra-row weeding machines in vineyards and for other crops.

The secretome of hepatocytes and hepatocellular carcinoma (HCC) cells can contribute to cancer progression. Here the authors show that PRSS35 inhibits HCC progression through proteolytic depletion of CXCL2 and subsequently decreased neutrophil recruitment to tumours.

Due to the increasing concern with the environmental safety and recyclability, natural fiber-reinforced composites have attracted more and more attention. In the present work, braking composite samples with and without wet granulation were fabricated and their physical, mechanical, and environmental properties were investigated systematically. The experimental results showed that the use of the wet granulation technology did not improve significantly the water absorption and impact strength properties of the braking composite samples but considerably improved their density and environmental performance in comparison to the braking composite sample without wet granulation, especially the environmental performance. Among the braking composite samples with wet granulation, with the decreasing of the resin contents, the density was decreased gradually, the water absorption was decreased and then increased, and the impact strength was increased. Samples FG-13 and FG-11 had a relatively low dust capacity, and sample FG-5 was the highest. The method of the braking composite preparation in the present work may serve as a useful guide to produce a strong low-resin environmental-friendly composite for automotive components.

Agricultural chemicals are commonly used to control pests and weeds, but cause pesticide waste problems. Oil-based emulsions are often used as pesticide formulations to improve pesticide utilization. In this study, the spray visualization experiment of the water and oil-based emulsion butachlor is carried out using an ST flat fan nozzle at 0.1–0.5 MPa pressure. The dimensionless method is used to analyze the difference in liquid sheet fragmentation morphology and disintegration process and the influence of different fragmentation methods on droplet size. It is found that the hydrophobic components in pesticide have a significant effect on the morphology and process of atomization fragmentation. When spray liquid is water, the liquid sheet breaks up into liquid ligaments due to the Rayleigh instability, then the ligaments break up into droplets. The side view of a liquid sheet is a large-amplitude wave disturbance. When the spray liquid is the emulsion butachlor, holes are generated on the liquid sheet, then the holes break up into droplets. The fragmentation method of emulsion spray is the perforation mechanism. Compared with water spray, the presence of the pesticide butachlor increases the droplet size and spray angle and improves the uniformity of droplet size distribution but reduces the breakup length. The spray angle shows a power law dependence of the Weber number with a power of 0.17 for all conditions tested here. At 0.3 MPa, DV50 increases 25%, and span decreases from 1.187 to 1.172. This study could provide reference for the addition of agricultural additives, the improvement of spray operation efficiency, and the establishment of spray fragmentation mechanism.

IntroductionHuman cytomegalovirus (HCMV) infection in infants can lead to severe diseases, including neonatal hepatitis. The single-cell dimensional changes in immune cells after the initial CMV infection remain elusive, as do the effects of CMV infection on hepatic lipid metabolism. MethodsWe employed single-cell RNA-sequencing to investigate the changes in liver cell types and immune responses in infant mice following murine CMV (MCMV) infection. Additionally, we examined alterations in protein expression profiles related to lipid metabolism in hepatocytes and the role of the key transcription factor PPAR-γ in hepatocytes during CMV infection. ResultsOur study revealed that MCMV infects most liver cell types in infant mice, leading to an increase in the proportion of proliferating CD8 effector T cells and a subset of Nos2+ monocytes, potentially playing an essential role in early anti-viral responses. Furthermore, MCMV infection resulted in altered protein expression of lipid metabolism in hepatocytes. Knocking down the transcription factor PPAR-γ in hepatocytes effectively inhibited CMV infection. DiscussionOur findings underscore the immune system's response to early-stage MCMV infection and the subsequent impact on hepatic lipid metabolism in infant mice. This research provides new insights into the mechanisms of CMV infection and could pave the way for novel therapeutic strategies.

In this study, a new series of quinoxalinone derivatives (5a–5p, 6a–6n) was designed and its hypoglycemic activity was evaluated. The results showed that compounds 5i and 6b exhibited stronger hypoglycemic effects than the lead compounds and were comparable to the positive control Pioglitazone. 5i and 6b may exert hypoglycemic effects by alleviating cellular OS and modulating the interactions among GLUT4, SGLT2, and GLUT1 proteins. The alleviating cellular OS of compound 6b was better than that of 5i, and 6b was found to bind better than 5i for most of the screening targets. In summary, compound 6b is a potential lead compound with hypoglycaemic activity.3

Air-assisted spraying technology is widely used in orchard sprayers to disturb canopy leaves and force droplets into the plant canopy to reduce droplet drift and increase spray penetration. A low-flow air-assisted sprayer was developed based on a self-designed air-assisted nozzle. The effects of the sprayer speed, spray distance, and nozzle arrangement angle on the deposit coverage, spray penetration, and deposit distribution were investigated in a vineyard by means of orthogonal tests. The optimal working conditions for the low-flow air-assisted sprayer working in the vineyard were determined as a sprayer speed of 0.65m/s, a spray distance of 0.9m, and a nozzle arrangement angle of 20°. The deposit coverages of the proximal canopy and intermediate canopy were 23.67% and 14.52%, respectively. The spray penetration was 0.3574. The variation coefficients of the deposit coverage of the proximal canopy and intermediate canopy, which indicate the uniformity of the deposition distribution, were 8.56% and 12.33%, respectively.

Portal vein tumor thrombus (PVTT) is very common and it plays a major role in the prognosis and clinical staging of hepatocellular carcinoma (HCC). We have published the first version of the guideline in 2016 and revised in 2018. Over the past several years, many new evidences for the treatment of PVTT become available, especially for the advent of new targeted drugs and immune checkpoint inhibitors which have further improved the prognosis of PVTT. So, the Chinese Association of Liver Cancer and Chinese Medical Doctor Association revised the 2018 version of the guideline to adapt to the development of PVTT treatment. Future treatment strategies for HCC with PVTT in China would depend on new evidences from more future clinical trials.

Background: Primary liver cancer, around 75%–85% are hepatocellular carcinoma in China, is the fourth most common malignancy and the second leading cause of tumor-related death, thereby posing a significant threat to the life and health of the Chinese people. Summary: Since the publication of Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China in June 2017, which were updated by the National Health Commission in December 2019, additional high-quality evidence has emerged from researchers worldwide regarding the diagnosis, staging, and treatment of liver cancer, that requires the guidelines to be updated again. The new edition (2022 Edition) was written by more than 100 experts in the field of liver cancer in China, which not only reflects the real-world situation in China, but also may re-shape the nationwide diagnosis and treatment of liver cancer. Key Messages: The new guideline aims to encourage the implementation of evidence-based practice, and improve the national average five-year survival rate for patients with liver cancer, as proposed in the "Health China 2030 Blueprint."

Abstract Metformin, the first-line drug for type II diabetes, has recently been considered an anticancer agent. However, the molecular target and underlying mechanism of metformin’s anti-cancer effects remain largely unclear. Herein, we report that metformin treatment increases the sensitivity of hepatocarcinoma cells to methotrexate (MTX) by suppressing the expression of the one-carbon metabolism enzyme DHFR. We show that the combination of metformin and MTX blocks nucleotide metabolism and thus effectively inhibits cell cycle progression and tumorigenesis. Mechanistically, metformin not only transcriptionally represses DHFR via E2F4 but also promotes lysosomal degradation of the DHFR protein. Notably, metformin dramatically increases the response of patient-derived hepatocarcinoma organoids to MTX without obvious toxicity to organoids derived from normal liver tissue. Taken together, our findings identify an important role for DHFR in the suppressive effects of metformin on therapeutic resistance, thus revealing a therapeutically targetable potential vulnerability in hepatocarcinoma.

Rockburst is a complex dynamic disaster in coal mining and affected by many factors. To accurately predict the rockburst hazard among complex influencing factors, a prediction model of rockburst hazard based on the Gaussian process for binary classification (GPC) was proposed after the identification of the intrinsic relationship between multiple factors of coal mines and rockburst. Through computerized machine learning and integrated intelligent analysis, the non-linear mapping of rockburst hazard and its influencing factors was established. The multi-factor pattern recognition model was constructed using artificial intelligence. The prediction criteria of the rockburst hazard probability and the hazard probability value of the prediction area unit were determined by applying neural network and fuzzy inference methods. In addition, the rockburst hazardous zone was classified, and the corresponding technical scheme for the prevention was put forward. The validity and feasibility of the regional prediction of rockburst hazard based on GPC were verified in the engineering practice. This method is highly targeted and can improve the accuracy and precision of rockburst prediction, thus contributing to the safe and efficient production of coal mines.

Abstract Background Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the medical costs associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the problem, we investigated the trend of direct medical costs and associated factors in patients with chronic HBV infection. Methods A retrospective cohort study of 65,175 outpatients and 12,649 inpatients was conducted using a hospital information system database for the period from 2008 to 2015. Generalized estimating equations (GEE) were applied to explore associations between annual direct medical costs and corresponding factors, meanwhile quantile regression models were used to evaluate the effect of treatment modes on different quantiles of annual direct medical costs stratified by medical insurances. Results The direct medical costs increased with time, but the proportion of antiviral costs decreased with CHB progression. Antiviral costs accounted 54.61% of total direct medical costs for outpatients, but only 6.17% for inpatients. Non-antiviral medicine costs (46.06%) and lab tests costs (23.63%) accounted for the majority of the cost for inpatients. The direct medical costs were positively associated with CHB progression and hospitalization days in inpatients. The direct medical costs were the highest in outpatients with medical insurance and in inpatients with free medical service, and treatment modes had different effects on the direct medical costs in patients with and without medical insurance. Conclusions CHB patients had a heavy economic burden in Guangzhou, China, which increased over time, which were influenced by payment mode and treatment mode.

Background: Hepatocellular carcinoma (HCC) is one of the most common malignancies in China. Most HCC patients are firstly diagnosed at an advanced stage, and systemic treatments are the mainstay of treatment. Summary: In recent years, immune checkpoint inhibitors have made a breakthrough in the systemic treatment of middle-advanced HCC, breaking the single therapeutic pattern of molecular targeted agents. To better guide the clinical treatment for effective and safe use of immunotherapeutic drugs, the Chinese Association of Liver Cancer and Chinese Medical Doctor Association has gathered multidisciplinary experts and scholars in relevant fields to formulate the “Chinese Clinical Expert Consensus on Immunotherapy for Hepatocellular Carcinoma (2021)” based on current clinical studies and clinical medication experience for reference in China. Key messages: The consensus contained 17 recommendations, including the preferred regimen for first- and second-line immunotherapy, evaluation and monitoring before/during/after treatment, management of complications, precautions for special patients and potential population for immunotherapy.

Background: Primary liver cancer, around 90% are hepatocellular carcinoma in China, is the fourth most common malignancy and the second leading cause of tumor-related death, thereby posing a significant threat to the life and health of the Chinese people. Summary: Since the publication of Guidelines for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition) in 2018, additional high-quality evidence has emerged with relevance to the diagnosis, staging, and treatment of liver cancer in and outside China that requires the guidelines to be updated. The new edition (2019 Edition) was written by more than 70 experts in the field of liver cancer in China. They reflect the real-world situation in China regarding diagnosing and treating liver cancer in recent years. Key Messages: Most importantly, the new guidelines were endorsed and promulgated by the Bureau of Medical Administration of the National Health Commission of the People’s Republic of China in December 2019.

The global incidence of liver cancer continues to grow. Liver cancer, especially hepatocellular carcinoma, has high recurrence and mortality rates. Here, we review the past decade's diagnostic, therapeutic, and management strategies for hepatocellular carcinoma, and summarize new patient management approaches, including enhanced recovery after surgery, targeted therapy, and immunotherapy. We compare traditional and innovative management methods, which comprise developments in precision medicine, and consider their limitations. Ongoing innovation and technological advances enable surgeons to gain deeper understandings of the multidimensionality of hepatocellular carcinoma, thereby promoting the continuous development of precision therapy.

This study aimed to evaluate the efficiency and safety of indocyanine green (ICG) fluorescence real-time imaging-guided technology in laparoscopic hepatectomy. A retrospective analysis of patients with primary liver cancer in the First Affiliated Hospital of USTC from January 2018 to October 2021, including 48 cases of fluorescence-guided laparoscopic hepatectomy (FGLH) and 60 cases of traditional laparoscopic hepatectomy (LH), was conducted. R0 resection rate, operation time, intraoperative blood loss, complications, hospital stay, and other intraoperative and postoperative indicators of the two groups were analyzed to determine the clinical feasibility and safety of ICG fluorescence real-time imaging-guided technology in laparoscopic hepatectomy. Related databases were searched for retrospective cohort studies and randomized controlled trials comparing FGLH with LH, studies were screened according to preset inclusion and exclusion criteria, literature quality was evaluated, and data were extracted. RevMan 5.3 software was used to conduct a meta-analysis on the extracted data. The results of our clinical data and meta-analysis showed that compared with LH, FGLH increased the R0 resection rate, shortened the operation time and postoperative hospital stay, and reduced blood loss and the occurrence of postoperative complications. Compared with LH, FGLH has a better application effect in laparoscopic hepatectomy, and it is worthy of promotion as it is safe and feasible.

Variable-rate spray systems with canopy leaf area density information detection are an important approach to reducing pesticide usage in orchard management. In order to estimate the canopy leaf area density using ultrasonic sensors, this article proposed three parameter model equations based on ultrasonic echo peaks for canopy leaf area density estimation and verified the accuracy of the three parameter model equations using laboratory-simulated canopy and outdoor tree experiments. The orthogonal regression statistics results from the laboratory-simulated canopy experiment indicated that parameter Vc is more suitable for canopy leaf area density estimation compared to parameter Va and Vb when the density ranges from 0.54 to 5.4 m2m−3. The model equation from parameter Vc has minor systematic errors, and the predicted and observed values of parameter Vc have good agreement with the experimental conditions. The laboratory-simulated canopy and outdoor tree canopy leaf area density verification experiments of parameter Vc were carried out, and the results indicated that the absolute value of the mean relative error is 5.37% in the laboratory-simulated canopy and 2.84% in outdoor tree experiments. The maximum absolute value of the relative error is 8.61% in the laboratory-simulated canopy and 14.71% in the outdoor tree experiments, and the minimum absolute value of the relative error is 3.21% in the laboratory-simulated canopy and 0.56% in the outdoor tree experiments. The laboratory-simulated canopy leaf area density verification results showed that the mean relative errors under canopy leaf area density 0.98 and 4.92 m2m−3 conditions are 6.29% and 5.82%, respectively, which is larger than the mean relative error under 2.95 m2m−3; nevertheless, these results proved that this model equation is applicable for canopy information detection and advanced pesticide application development in future.

The dynamic evaporation of single droplets was investigated under controlled conditions. In the evaporation process, a droplet was placed on a peach leaf surface. In this research, the relative humidity and temperature were kept constant, and the wind speeds and thiophanate-methyl concentrations varied. Based on these conditions, this study aimed to determine the droplets’ dynamic transforming characteristics, including the contact angle, the height of the droplets, and the evaporation rate. Five concentrations and five wind speeds were chosen, and pure water droplets at different wind speeds were used as a control group. All single droplets were generated by a syringe. The results showed that the pure water and thiophanate-methyl droplets’ evaporation mode was CCR (constant contact radius) mode. An increase in the wind speed accelerated the evaporation process, when the wind speed was 0 m/s, the evaporation was the longest, and the shortest evaporation was achieved with 2.0 m/s wind speed. An increase in wind speed enhanced the pure water droplets’ dynamic evaporation process with a maximum enhancement ratio of 3.44 times in the present work. Under the same conditions, the thiophanate-methyl droplets’ evaporation time was shorter than that of the pure water droplets. For thiophanate-methyl droplets, the higher the concentration, the shorter the dynamic evaporation process. A 1250 ppm thiophanate-methyl solution with 2.0 m/s wind speed, had an evaporation ratio that was 2.83 times greater than that measured with 0 m/s wind speed. These results could benefit farmers by suggesting that they should adjust the concentration of thiophanate-methyl depending on the wind speed in order to reduce pollution.

High clearance sprayer is a high-efficiency pesticide application machine in orchard management. In this paper, operational safety of high clearance sprayers is validated by using finite element simulation and vibration testing. The 3D model of the frame is simplified by using shell units instead of solid units, the static performance of high clearance sprayer frames under static full load and ultimate torsional conditions was studied by means of finite element simulation tests, the mechanical properties of the frame under step excitation were studied by multi-body dynamic simulation test. The simulation results show that, at a safety factor of 1.5, the maximum stress extremes in the frame are within the safe permissible stress range. During the dynamics analysis, a tire-ground contact simplified model was proposed. The results of the modal analysis show that the inherent frequency distribution of the high clearance sprayer is compact, and the vibration test has measured a large difference between the engine vibration frequency with the inherent frequency of the frame, this means that resonance will not occur. The theoretical analysis shows that the designed high clearance sprayer meets the requirements of large cross-row field operations, the study provides a reference for the overall design of the high clearance sprayer.

To realize the online evaluation of spray quality, an online measuring system for spray coverage and deposition quality is developed. The measuring theory of spray coverage and deposition quality on an LWS (leaf wetness sensor) surface is analyzed. When the spray conditions are constant, there is a linear correlation between the spray coverage on the sensor surface, the spray deposition quality and the LWS output voltage increment. The results of calibration experiments show that when the spray conditions are constant, the coefficient of determination R2 of the regression curves between the sensor output voltage increment and the spray coverage on the sensor surface is more than 0.75, and the coefficient of determination R2 of the regression curves between the sensor output voltage increment and the spray deposition quality on the sensor surface is more than 0.90. Based on ZigBee wireless sensor technology, this paper reports an online measuring system for spray coverage and deposition quality at multiple points in the field. The test results show that the online measuring system has good uniformity. Field test results show that the LWS voltage increment and the coverage rate of water-sensitive paper have a good correlation, and the measuring results of the spray deposition quality trend are in good agreement. The fit of the spray deposition quality curves measured by the two methods was 0.8924. The research results in this paper can provide a reference for using LWS sensors to measure spray coverage and deposition quality.

An air-assisted electrostatic nozzle uses a combination of air-assisted atomization and electrostatic spray technology. This article optimizes the existing air-assisted electrostatic nozzles in terms of structural design to obtain a higher charge-to-mass ratio and a smaller droplet size. The optimized air-assisted electrostatic nozzle was studied experimentally, and the effects of liquid pressure, air pressure and applied voltage on the droplet size and charge-to-mass ratio were investigated. Comparing the effects of air pressure, liquid pressure and applied voltage on the charge-to-mass ratio and droplet size, the relationship curves of the droplet size and charge-to-mass ratio under each voltage were fitted using the Rayleigh charge limit theory. For a higher CMR during the spray operation, applied voltages between 2.5 kV and 3 kV, an air pressure between 0.4 bar and 0.6 bar, and a liquid pressure of less than 0.9 bar could be chosen. The optimized air-assisted electrostatic nozzles not only have small droplets but also have high charge-to-mass ratios, reducing the need for pesticide use and thus protecting human health and the environment.

In the process of applying plant protection sprays, the atomisation process of complex pesticide components such as emulsion pesticides is different from that of water. Indeed, emulsion is often used as an additive to spray to reduce drift. Therefore, this study investigated the different morphological characteristics that occur between emulsions and water during atomisation at different pressures through visualisation experiments and interpreting the formation of structural differences between the two fragmentation mechanisms. The effect of liquid sheet structure on droplet size distribution was analysed in three-dimensional space, not only from one spatial perspective, but how it alters the morphological structures of liquid sheet leading to different potential droplet drift characteristics. It was found that the smaller the liquid sheet disturbance, the more concentrated the droplet size distribution, the more intense the liquid sheet disturbance, the more dispersed the droplet size distribution. The addition of 0.02% emulsion significantly reduced the proportion of V100 (the ratio of volume with drops smaller than 100 μm to the total volume of all droplets) from 21.33% to 10.24%, and the higher the emulsion concentration, the smaller the V100. The ability of the emulsion to increase V400 decreased with increasing pressure.

As one of the most serious shock dynamic disasters in coal mining, rock burst only occurs under the certain geodynamic environment. Geodynamic is the necessary requirement for the occurrence of rock burst, and the disturbance of mining engineering is the sufficient requirement. In terms of the fault structure, the method of geodynamic zoning is used to classify fault structure forms of rock burst in mines, and a model of geological structure is established to reveal the connection between fault structure and mine engineering. Besides, the influence of fault structure on rock burst is analyzed, and the controlling mechanism of the fault structure on the tectonic evolution of the mine area and the occurrence of rock burst is revealed. This research provides a treatment plan for the prediction and prevention of rock burst and guides the safe production in the coal mining engineering.

Objective To identify the factors influencing early recurrence in patients with hepatocellular carcinoma (HCC) after curative resection. Methods Clinical data for 99 patients with HCC undergoing curative resection were analyzed. The clinicopathological factors influencing early recurrence were analyzed by Cox regression. Results Twenty-five of 99 patients (25.3%) suffered from early recurrence. There were significant differences between patients with and without recurrence in terms of tumor diameter, tumor capsular integrity, and preoperative alpha fetoprotein level. Cox regression analysis revealed that a tumor diameter >2.6 cm and preoperatively increased total bilirubin (TBL) level were risk factors for postoperative recurrence, while tumor capsular integrity had a protective effect on postoperative recurrence. After adjusting for preoperative TBL level and tumor capsular integrity, the risk of HCC recurrence was markedly increased in line with increasing tumor diameter in a non-linear manner. Conclusion Tumor diameter >2.6 cm and preoperatively increased TBL level are associated with a higher risk of early recurrence after curative resection in patients with HCC, while tumor capsular integrity is associated with a lower risk of early recurrence.

Summary: Enhanced recovery after surgery (ERAS) is a series of perioperative optimized treatment measures based on evidence-based medicine which can control perioperative pathological and physiological responses, reduce surgical trauma and postoperative stress, and then achieve rapid recovery. This is a new concept in the 21st century, which is a revolution to the medical treatment and rehabilitation mode. Based on the clinical application study and expert experience in present ERAS in hepatectomy field at home and abroad, Chinese Expert Consensus on Enhanced Recovery After Hepatectomy (Version 2017) is established. The Chinese Expert consensus is the first guideline in the area of ERAS in hepatic surgery in China, which is drafted by the committee organized by Chinese Medical Association and China International Exchange and Promotive Association for Medical and Health Care. Keywords: Hepatectomy, Enhanced recovery after surgery, Consensus

The accurate detection of canopy characteristics is the basis of precise variable spraying. Canopy characteristics such as canopy density, thickness and volume are needed to vary the pesticide application rate and adjust the spray flow rate and air supply volume. Canopy thickness is an important canopy dimension for the calculation of tree canopy volume in pesticide variable spraying. With regard to the phenomenon of ultrasonic waves with multiple reflections and the further analysis of echo signals, we found that there is a proportional relationship between the canopy thickness and echo interval time. In this paper, we propose a method to calculate canopy thickness using echo signals that come from ultrasonic sensors. To investigate the application of this method, we conducted a set of lab-based experiments with a simulated canopy. The results show that we can accurately estimate canopy thickness when the detection distance, canopy density, and canopy thickness range between 0.5and 1.5 m, 1.2 and 1.4, and 0.3and 0.6 m, respectively. The relative error between the estimated value and actual value of the simulated canopy thickness is no higher than 8.8%. To compare our lab results with trees in the field, we measured canopy thickness from three naturally occurring Osmanthus trees (Osmanthus fragrans Lour). The results showed that the mean relative errors of three Osmanthus trees are 19.2%, 19.4% and 18.8%, respectively. These results can be used to improve measurements for agricultural production that includes both orchards and facilities by providing a reference point for the precise application of variable spraying.

The evolution of jet surface structure plays a key role in various atomization related applications. In this paper, the jet surface structures of two different nozzle configurations are captured and measured based on high-speed microscopic photography and a novel image processing method. Results show that the primary wavelength of surface wave decreases exponentially with Weber number and increases linearly with streamwise distance for both two nozzles. The primary wavelength that non-dimensionalized with boundary layer thickness is almost a constant for the same nozzle, but obviously different for different nozzles. The nozzle configuration has a significant effect on the scale of the surface structure when the Weber number is smaller than 50, however, this effect is limited for bigger Weber number. Keywords: Liquid jet, Surface structure, Image processing, Wavelength, Nozzle configuration

The authors wish to make the following correction to this paper [...]

Rapid detection of spraying deposit can contribute to the precision application of plant protection products. In this study, a novel capacitor sensor system was implemented for measuring the spray deposit immediately after herbicide application. Herbicides with different formulations and nozzles in different mode types were included to test the impact on the capacitance of this system. The results showed that there was a linear relationship between the deposit mass and the digital voltage signals of the capacitance on the sensor surface with spray droplets. The linear models were similar for water and the spray mixtures with non-ionized herbicides usually in formulations of emulsifiable concentrates and suspension concentrates. However, the ionized herbicides in formulation of aqueous solutions presented a unique linear model. With this novel sensor, it is possible to monitor the deposit mass in real-time shortly after the pesticide application. This will contribute to the precision application of plant protection chemicals in the fields.

Herbicide resistant weeds need to be identified early so that yield loss can be avoided by applying proper field management strategies. A novel chlorophyll-fluorescence-imaging sensor has been developed to conduct real-time herbicide effect evaluation. In this research, greenhouse and field experiments were conducted to calibrate the capability of the sensor in monitoring herbicide effects on different biotypes of two grass weeds (Alopecurus myosuroides, Apera spica-venti) in southwestern Germany. Herbicides with different modes of action were applied for the effect monitoring. Chlorophyll fluorescence yield of the plants was measured 3⁻15 days after treatment (DAT) using the new fluorescence sensor. Visual assessment of the weeds was carried out on 21 DAT. The results showed that the maximal PS II quantum yield (Fv/Fm) of herbicide sensitive weeds was significantly lower than the values of resistant populations in 5 DAT. The new technology was capable of quickly identifying the herbicide’s effect on plants. It can be used to optimize management strategies to control herbicide resistant weeds.

Background: Three-dimensional reconstruction visualization technology (3D-RVT) is an important tool in the preoperative assessment of patients undergoing liver resection. However, it is not clear whether this technique can improve short-term and longterm outcomes in patients with hepatocellular carcinoma (HCC) compared with two-dimensional (2D) imaging. Method: A total of 3402 patients from five centers were consecutively enrolled from January 2016 to December 2020, and grouped based on the use of 3D-RVT or 2D imaging for preoperative assessment. Baseline characteristics were balanced using propensity score matching (PSM, 1:1) and stabilized inverse probability of treatment-weighting (IPTW) to reduce potential selection bias. The perioperative outcomes, long-term overall survival (OS), and recurrence-free survival (RFS) were compared between the two groups. Cox-regression analysis was used to identify the risk factors associated with RFS. Results: A total of 1681 patients underwent 3D-RVT assessment before hepatectomy (3D group), while 1721 patients used 2D assessment (2D group). The PSM cohort included 892 patient pairs. In the IPTW cohort, there were 1608.3 patients in the 3D group and 1777.9 patients in the 2D group. In both cohorts, the 3D group had shorter operation times, lower morbidity and liver failure rates, as well as shorter postoperative hospital stays. The 3D group had more margins ≥10 mm and better RFS than the 2D group. The presence of tumors with a diameter ≥ 5 cm, intraoperative blood transfusion and multiple tumors were identified as independent risk factors for RFS, while 3D assessment and anatomical resection were independent protective factors. Conclusion: In this multicenter study, perioperative outcomes and RFS of HCC patients following 3D-RVT assessment were significantly different from those following 2D imaging assessment. Thus, 3D-RVT may be a feasible alternative assessment method before hepatectomy for these patients. [ABSTRACT FROM AUTHOR]

Current methods synthetic aperture radar–automatic target recognition (SAR–ATR) research methods still struggle with overfitting due to small amounts of training data, as well as black-box opacity and high computational requirements. Unmanned aerial vehicles, as the mainstream means of acquiring SAR data, place higher requirements on ATR algorithms due to their flexible maneuvering characteristics. This article starts by studying the electromagnetic (EM) backscattering mechanism and the physical properties of SAR. We construct a heterogeneous graph for the first time to fully exploit both the EM scattering information of the target components and their interactions. Moreover, the multilevel multihead attention mechanism is introduced to the graph net to learn features from various topological structure levels. Additionally, we include a convolutional neural network based feature extraction net to replenish intuitive visual features. The above two nets form the lightweight dual-stream framework (LDSF). LDSF uses a feature fusion subnetwork to adaptively fuse the dual-stream features to maximize the final classification performance. The experiments use two more rigorous evaluation protocols on MSTAR and OpenSARShip, namely, once-for-all and less-for-more, which can rigorously assess the efficacy and generalization capability of the algorithms. The superiority of LDSF is verified.