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IMPORTANCE: Splenic hilar lymphadenectomy has been recommended for locally advanced proximal gastric cancer (APGC) involving the greater curvature. However, it is unclear whether laparoscopic spleen-preserving splenic hilar lymphadenectomy (LSPSHL) is associated with a long-term survival benefit for APGC without greater curvature invasion. OBJECTIVE: To present the 5-year follow-up data from a randomized clinical trial that compared laparoscopic total gastrectomy (D2 group) with D2 plus LSPSHL (D2 + No. 10 group) among patients with resectable APGC. DESIGN, SETTING, AND PARTICIPANTS: This is a post hoc secondary analysis of a randomized clinical trial that enrolled 536 patients with potentially resectable APGC (cT2-4a, N0 or N+, and M0) without greater curvature invasion from January 5, 2015, to October 10, 2018. All patients were tracked for at least 5 years. The final follow-up was on October 30, 2023. INTERVENTIONS: Patients were randomly assigned in a 1:1 ratio to the D2 + No. 10 or D2 groups. MAIN OUTCOMES AND MEASURES: The 5-year disease-free survival (DFS) and overall survival (OS) rates were measured. Recurrence patterns and causes of death were compared. RESULTS: A total of 526 patients (392 men [74.5%]; mean [SD] age, 60.6 [9.6] years) were included in the modified intent-to-treat analysis, with 263 patients in each group. The 5-year DFS rate was 63.9% (95% CI, 58.1%-69.7%) for the D2 + No. 10 group and 55.1% (95% CI, 49.1%-61.1%) for the D2 group (log-rank P = .04). A statistically significant difference was observed in the 5-year OS between the D2 + No. 10 group and the D2 group (66.2% [95% CI, 60.4%-71.9%] vs 57.4% [95% CI, 51.4%-63.4%]; log-rank P = .03). The No. 10 lymph node exhibited a therapeutic value index (TVI) of 6.5, surpassing that of Nos. 8a (TVI, 3.0), 11 (TVI, 5.8), and 12a (TVI, 0.8). A total of 86 patients in the D2 + No. 10 group (cumulative incidence, 32.7%) and 111 patients in the D2 group (cumulative incidence, 42.2%) experienced recurrence (hazard ratio, 0.72; 95% CI, 0.54-0.95; P = .02). The multivariable competing risk regression model demonstrated that D2 + No. 10 remained an independent protective factor for a lower 5-year cumulative recurrence rate after surgery (hazard ratio, 0.75; 95% CI, 0.56-1.00; P = .05). There was a significant difference in the 5-year cumulative recurrence rate at the No. 10 lymph node area between the 2 groups (D2 + No. 10 group vs D2 group: 0% vs 2.3% [n = 6]; P = .01). CONCLUSIONS: This post hoc secondary analysis of a randomized clinical trial found that laparoscopic total gastrectomy with LSPSHL can improve the prognosis and reduce recurrence for APGC without greater curvature invasion. Future multicenter studies are warranted to validate these findings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02333721

Background: The role of minimally invasive surgery using robotics versus laparoscopy in resectable gastric cancer patients with a high body mass index (BMI) remains controversial. Methods: A total of 482 gastric adenocarcinoma patients with BMI ≥ 25 kg/m2who underwent minimally invasive radical gastrectomy between August 2016 and December 2019 were retrospectively analyzed, including 109 cases in the robotic gastrectomy (RG) group and 321 cases in the laparoscopic gastrectomy (LG) group. Propensity score matching (PSM) with a 1:1 ratio was performed, and the perioperative outcomes, lymph node dissection, and 3-year overall survival (OS) and disease-free survival (DFS) rates were compared. Results: After PSM, 109 patients were included in each of the RG and LG groups, with balanced baseline characteristics. Compared with the LG group, the RG group had similar intraoperative estimated blood loss [median (IQR) 30 (20–50) vs. 35 (30–59) mL, median difference (95%CI) − 5 (− 10 to 0)], postoperative complications [13.8% vs. 18.3%, OR (95%CI) 0.71 (0.342 to 1.473)], postoperative recovery, total harvested lymph nodes [(34.25 ± 13.43 vs. 35.44 ± 14.12, mean difference (95%CI) − 1.19 (− 4.871 to 2.485)] and textbook outcomes [(81.7% vs. 76.1%, OR (95%CI) 1.39 (0.724 to 2.684)]. Among pathological stage II–III patients receiving chemotherapy, the initiation of adjuvant chemotherapy in the RG group was similar to that in the LG group [median (IQR): 28 (25.5–32.5) vs. 32 (27–38.5) days, median difference (95%CI) − 3 (− 6 to 0)]. The 3-year OS (RG vs. LG: 80.7% vs. 81.7%, HR = 1.048, 95%CI 0.591 to 1.857) and DFS (78% vs. 76.1%, HR = 0.996, 95%CI 0.584 to 1.698) were comparable between the two groups. Conclusion: RG conferred comparable lymph node dissection, postoperative recovery, and oncologic outcomes in a selected cohort of patients with BMI ≥ 25 kg/m2.

In our study, we introduce a novel concept concerning the formation of oxygen vacancies at varying temperatures during oxide skin formation in liquid metal. Specifically, by adjusting the 2D-InOxprinting temperatures, we successfully regulated the concentration of specific defects, unveiling a decrease in oxygen vacancies at higher printing temperatures. Employing a comprehensive suite of analytical techniques, we present a swift and efficient method for producing 2D-InOxwhile simultaneously evaluating its internal defect content at both the macroscopic and microscopic levels. Furthermore, we employed electron energy loss spectroscopy (EELS) scans in the proximity of grain boundaries, enabling us to effectively probe the fluctuation in oxygen vacancy concentration between these boundaries and the interior of the grains. Our findings underscore a notable accumulation of oxygen vacancies at these grain boundaries. Notably, our capacity to manipulate defect concentration through temperature adjustments enhances the significance of our investigation, offering valuable insights into 2D memristor materials and their potential role in the development of memory devices based on 2D-InOx.

Objective: Textbook outcome (TO) is widely recognized as a comprehensive prognostic indication for patients with gastric cancer (GC). This study aims to develop a modified TO (mTO) for elderly patients with GC. Methods: Data from the elderly patients (aged ≥ 65 years) in two Chinese tertiary referral hospitals were analyzed. 1389 patients from Fujian Medical University Union Hospital were assigned as the training cohort and 185 patients from Affiliated Hospital of Putian University as the validation cohort. Nomogram was developed by the independent prognostic factors of Overall Survival (OS) based on Cox regression. Results: In the training cohort, laparoscopic surgery was significantly correlated with higher TO rate (P< 0.05). Cox regression analysis revealed that surgical approach was also an independent factor of OS (P< 0.001), distinct from the traditional TO. In light of these findings, TO parameters were enhanced by the inclusion of surgical approach, rendering a modified TO (mTO). Further analysis showed that mTO, tumor size, pTNM staging, and adjuvant chemotherapy were independent prognostic factors associated with OS (all P< 0.05). Additionally, the nomogram incorporating these four indicators accurately predicted 1-, 3-, and 5-year OS in the training cohort, with AUC values of 0.793, 0.814, and 0.807, respectively, and exhibited outstanding predictive performance within the validation cohort. Conclusion: mTO holds a robust association with the prognosis of elderly patients with GC, meriting intensified attention in efforts aimed at enhancing surgical quality. Furthermore, the predictive model incorporating mTO demonstrates excellent predictive performance for elderly patients with GC.

Feature pyramid representations have been widely adopted in the object detection literature for better handling of variations in scale, which provide abundant information from various spatial levels for classification and localization sub-tasks. We find that inter sub-task feature disentanglement and intra sub-task feature re-fusion are crucial for final prediction performance, but are hard to be achieved simultaneously considering the computational efficiency. We find this issue can be addressed by delicate module design. In this paper, we propose an Efficient Task-specific Feature Re-fusion (ETFR) module to mitigate the dilemma. ETFR disentangles inter sub-task features, reduces the output channels of multi-scale features based on their importance and re-fuses intra sub-task features via concatenation operation. As a plug-and-play module, ETFR can remarkably and consistently improve the well-established and highly-optimized object detection and instance segmentation methods, such as RetinaNet, FCOS, BlendMask and CondInst, with neglectable extra computation cost. Extensive experiments demonstrate that ETFR has good generalization ability on various changeling datasets, including COCO, LVIS and Cityscapes.

Three-dimensional point cloud classification is fundamental but still challenging in 3-D vision. Existing graph-based deep learning methods fail to learn both low-level extrinsic and high-level intrinsic features together. These two levels of features are critical to improving classification accuracy. To this end, we propose a dual-graph attention convolution network (DGACN). The idea of DGACN is to use two types of graph attention convolution operations with a feedback graph feature fusion mechanism. Specifically, we exploit graph geometric attention convolution to capture low-level extrinsic features in 3-D space. Furthermore, we apply graph embedding attention convolution to learn multiscale low-level extrinsic and high-level intrinsic fused graph features together. Moreover, the points belonging to different parts in real-world 3-D point cloud objects are distinguished, which results in more robust performance for 3-D point cloud classification tasks than other competitive methods, in practice. Our extensive experimental results show that the proposed network achieves state-of-the-art performance on both the synthetic ModelNet40 and real-world ScanObjectNN datasets.

Background: Textbook outcome (TO) has been widely employed as a comprehensive indicator to assess the short-term prognosis of patients with cancer. Preoperative malnutrition is a potential risk factor for adverse surgical outcomes in patients with gastric cancer (GC). This study aimed to compare the TO between robotic-assisted gastrectomy (RAG) and laparoscopic-assisted gastrectomy (LAG) in malnourished patients with GC. Methods: According to the diagnostic consensus of malnutrition proposed by Global Leadership Initiative on Malnutrition (GLIM) and Nutrition Risk Index (NRI), 895 malnourished patients with GC who underwent RAG (n= 115) or LAG (n= 780) at a tertiary referral hospital between January 2016 and May 2021 were included in the propensity score matching (PSM, 1:2) analysis. Results: After PSM, no significant differences in clinicopathological characteristics were observed between the RAG (n= 97) and LAG (n= 194) groups. The RAG group had significantly higher operative time and lymph nodes harvested, as well as significantly lower blood loss and hospital stay time compared to the LAG group. More patients in the RAG achieved TO. Logistic regression analysis revealed that RAG was an independent protective factor for achieving TO. There were more adjuvant chemotherapy (AC) cycles in the RAG group than in the LAG group. After one year of surgery, a higher percentage of patients (36.7% vs. 22.8%; P< 0.05) in the RAG group recovered from malnutrition compared to the LAG group. Conclusions: For malnourished patients with GC, RAG performed by experienced surgeons can achieved a higher rate of TO than those of LAG, which directly contributed to better AC compliance and a faster restoration of nutritional status.

Head-pose estimation plays an important role in computer vision. The head-pose estimation aims to determine the orientation of a human head by representing the yaw, pitch, and roll angles. Implementations can be achieved by different techniques depending on the type of input and training data. This article presents a simple three-dimensional (3-D) face model for estimating head poses. The personalized 3-D face model is constructed by 2-D face photographs. A frontal face photograph determines the plane coordinates of facial features. By knowing the yaw angles in the other averted face photograph, the depth coordinates can be determined. The yaw angle of the averted face is evaluated by the canthus positions. Once the 3-D face model is constructed, we can find the matching angles for a target head pose in a query 2-D photograph. The personalized 3-D face model rotates itself about the x-, y-, and z-axes and then projects its facial features onto plane coordinates. If the rotation angles are correct, the disparities between the 2-D facial features and those in the query face photograph are supposed to be at their minimum. The personalized 3-D face model is validated with the University of South Florida human-identification database. The performance of the proposed head-pose estimation is evaluated on the Biwi Kinect head-pose database and Pointing’04 head-pose image database. The results show that the proposed method outperforms state-of-the-art technologies on both benchmark databases.

Background: Surgical quality control is a crucial determinant of evaluating the tumor efficacy. Objective: To assess the ClassIntra grade for quality control and oncological outcomes of robotic radical surgery for gastric cancer (GC). Methods: Data of patients undergoing robotic radical surgery for GC at a high-volume center were retrospectively analyzed. Patients were categorized into two groups, the intraoperative adverse event (iAE) group and the non-iAE group, based on the occurrence of intraoperative adverse events. The iAEs were further classified into five sublevels (ranging from I to V according to severity) based on the ClassIntra grade. Surgical performance was assessed using the Objective Structured Assessment of Technical Skill (OSATS) and the General Error Reporting Tool. Results: This study included 366 patients (iAE group: n= 72 [19.7%] and non-iAE group: n= 294 [80.3%]). The proportion of ClassIntra grade II patients was the highest in the iAE group (54.2%). In total and distal gastrectomies, iAEs occurred most frequently in the suprapancreatic area (50.0% and 54.8%, respectively). In total gastrectomy, grade IV iAEs were most common during lymph node dissection in the splenic hilum area (once for bleeding [grade IV] and once for injury [grade IV]). The overall survival (OS) and disease-free survival of the non-iAE group were significantly better than those of the iAE group (Log rank P< 0.001). Uni- and multi-variate analyses showed that iAEs were key prognostic indicators, independent of tumor stage and adjuvant chemotherapy (P< 0.001). Conclusion: iAEs in patients who underwent robotic radical gastrectomy significantly correlated with the occurrence of postoperative complications and a poor long-term prognosis. Therefore, utilization and inclusion of ClassIntra grading as a crucial surgical quality control and prognostic indicator in the routine surgical quality evaluation system are recommended.

Perceptual learning is the process by which experience alters how incoming sensory information is processed by the brain to give rise to behavior—it is critical for how humans educate children, train experts, treat diseases, and promote health and well-being throughout the lifespan. Knowledge of perceptual learning requires basic and applied research in humans and nonhuman animal models, which informs strategic targets for advancing applications. Commercial products to induce perceptual learning are proliferating rapidly with limited regulation (e.g., for rehabilitation), while at the same time basic science is increasingly restricted by changing regulations (such as new granting-agency definitions of clinical trials). Realizing the full potential of perceptual learning requires balancing basic and translational science to advance new knowledge, while serving and protecting consumers. Reforms can promote open, accessible, and representative research, and the translation of this research to applications across different sectors of society.

Importance: It is largely unclear whether robotic distal gastrectomy (RDG) is cost-effective for locally advanced gastric cancer (LAGC). Objective: To evaluate the cost-effectiveness of RDG, laparoscopic distal gastrectomy (LDG), and open distal gastrectomy (ODG) for patients with LAGC. Design, setting, and participants: Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics. A decision-analytic model was constructed to evaluate the cost-effectiveness of RDG, LDG, and ODG. Exposures: RDG, LDG, and ODG. Main outcomes and measures: Incremental cost-effectiveness ratio (ICER) and quality-adjusted life year (QALY). Results: This pooled analysis of two randomized controlled trials included 449 patients: 117, 254, and 78 patients in the RDG, LDG, and ODG groups, respectively. After IPTW, RDG demonstrated its priority in terms of less blood loss, postoperative length, and complication rate (all P< 0.05). RDG also showed higher QOL with more cost, representing an ICER of $85,739.73 per QALY and $42,189.53 per QALY compared to LDG and ODG, respectively. In probabilistic sensitivity analysis, RDG achieved the best cost-effectiveness for patients with LAGC only when the willingness-to-pay threshold was > $85,739.73 per QALY, which significantly exceeded 3 times Chinese per capita GDP. Furthermore, one of the most important factors was the indirect costs of robotic surgery in terms of the cost-effectiveness of RDG compared to that of LDG or ODG. Conclusions and relevance: Although improved short-term outcomes and QOL were seen in patients underwent RDG, the economic burden should be considered in the clinical decision-making regarding robotic surgery use for patients with LAGC. Our findings may vary in different health care settings and affordability.

Neutron imaging technology as a means of non-destructive detection of materials is complementary to X-ray imaging. Silicon photomultiplier (SiPM), a new type of optical readout device, has overcome some shortcomings of traditional photomultiplier tube (PMT), such as high-power consumption, large volume, high price, uneven gain response, and inability to work in strong magnetic fields. Its application in the field of neutron detection will be an irresistible general trend. In this paper, a thermal neutron imaging detector based on 6LiF/ZnS scintillation screen and SiPM array readout was developed. The design of the detector geometry was optimized by geant4 Monte Carlo simulation software. The optimized detector was evaluated with a step wedge sample. The results show that the detector prototype with a 48 mm × 48 mm sensitive area can achieve about 38% detection efficiency and 0.26 mm position resolution when using a 300 μm thick 6LiF/ZnS scintillation screen and a 2 mm thick Bk7 optical guide coupled with SiPM array, and has good neutron imaging capability. It provides effective data support for developing high-performance imaging detectors applied to the China Spallation Neutron Source (CSNS).

ABSTRACTMacroautophagy/autophagy is an evolutionarily conserved biological process among eukaryotes that degrades unwanted materials such as protein aggregates, damaged mitochondria and even viruses to maintain cell survival. Our previous studies have demonstrated that MoVast1 acts as an autophagy regulator regulating autophagy, membrane tension, and sterol homeostasis in rice blast fungus. However, the detailed regulatory relationships between autophagy and VASt domain proteins remain unsolved. Here, we identified another VASt domain-containing protein, MoVast2, and further uncovered the regulatory mechanism of MoVast2 in M. oryzae. MoVast2 interacted with MoVast1 and MoAtg8, and colocalized at the PAS and deletion of MoVAST2results in inappropriate autophagy progress. Through TOR activity analysis, sterols and sphingolipid content detection, we found high sterol accumulation in the ΔMovast2mutant, whereas this mutant showed low sphingolipids and low activity of both TORC1 and TORC2. In addition, MoVast2 colocalized with MoVast1. The localization of MoVast2 in the MoVAST1deletion mutant was normal; however, deletion of MoVAST2leads to mislocalization of MoVast1. Notably, the wide-target lipidomic analyses revealed significant changes in sterols and sphingolipids, the major PM components, in the ΔMovast2mutant, which was involved in lipid metabolism and autophagic pathways. These findings confirmed that the functions of MoVast1 were regulated by MoVast2, revealing that MoVast2 combined with MoVast1 maintained lipid homeostasis and autophagy balance by regulating TOR activity in M. oryzae.

Background: Laparoscopic technique has been increasingly used in gastrectomy, but the safety and feasibility of the laparoscopic total gastrectomy (LTG) for advanced proximal gastric cancer (PGC) after neoadjuvant chemotherapy (NAC) is unclear. Methods: A retrospective analysis of 146 patients who received NAC followed by radical total gastrectomy at Fujian Medical University Union Hospital from January 2008 to December 2018 was performed. The primary endpoints were long-term outcomes. Results: The patients were divided into two groups: 89 were in the LTG group and 57 were in the open total gastrectomy (OTG) group. The LTG group had a significantly shorter operative time (median 173 min vs. 215 min, p< 0.001), less intraoperative bleeding (62 ml vs. 135 ml, p< 0.001), higher total lymph node (LN) dissections (36 vs 31, p= 0.043), and higher total chemotherapy cycle completion rate (≥ 8 cycles) (37.1% vs. 19.7%, p= 0.027) than OTG. The 3-year overall survival (OS) of the LTG group was significantly higher than that of the OTG group (60.7% vs. 35%, p= 0.0013). Survival with inverse probability weighting(IPW) correction for Lauren type, ypTNM stage, NAC schemes and the times at which the surgery was performed showed that there was no significant difference in OS between the two groups (p= 0.463). Postoperative complications (25.8% vs. 33.3%, p= 0.215) and recurrence-free survival (RFS) (p= 0.561) between the LTG and OTG groups were also comparable. Conclusion: In experienced gastric cancer surgery centers, LTG is recommended as the preferred option for such patients who performed NAC, owing to its long-term survival is not inferior to OTG, and it offers less intraoperative bleeding, better chemotherapy tolerance than conventional open surgery.

Prostate cancer is one of the most common cancers in men. This study was conducted to investigate the role of euchromatic histone lysine methyltransferase 2 (EHMT2) and endoplasmic reticulum protein 29 (ERP29) in the progression of radioresistance in prostate cancer. The expression of EHMT2 and ERP29 in prostate cancer cells and during the progression of radioresistance was detected using quantitative reverse transcription‐polymerase chain reaction and western blotting, and the interaction between EHMT2 and ERP29 was investigated. The proliferation of transfected cells under x‐ray irradiation was determined using the methyl thiazolyl tetrazolium and colony formation assays. Flow cytometry was used to analyze the apoptosis of the transfected cells under x‐ray irradiation. Nude mice were subcutaneously injected with prostate cancer (DU145) cells stably transfected with sh‐ERP29 or sh‐NC. The effect of ERP29 expression on radioresistance in nude mice was assessed by x‐ray irradiation. The expression of EHMT2 was upregulated and that of ERP29 was downregulated in prostate cancer cells during radioresistance progression. EHMT2 downregulation suppressed radioresistance in DU145 and androgen‐sensitive prostate cancer (LNCaP) cells. In irradiated DU145 cells, EHMT2 inhibition decreased the number of colonies and accelerated apoptosis. The transcription of ERP29 was suppressed by EHMT2 by upregulating H3K9me2 and downregulating H3K4me3, thereby regulating radioresistance in prostate cancer cells. In addition, the downregulation of ERP29 promoted the progression of radioresistance in prostate cancer cells in nude mice. EHMT2 promotes radioresistance in prostate cancer cells by repressing ERP29 transcription.

A Si–40Al joining transition layer was prepared via laser cladding, followed by brazing of SiC ceramics using Si–60Al alloy as the joint filler. The microstructure, composition, and flexural strength of the brazed joints were investigated under different brazing temperatures and holding times. The corrosion resistance of the joints was evaluated using a hydrochloric acid immersion test. The laser cladding layer effectively reduced interfacial stress, enhanced interfacial bonding, and suppressed the formation of brittle intermetallic compounds. The main constituents of the brazed joint were Si, Al2O3, and SiC, with newly formed SiC at the interface promoting interfacial bonding. The flexural strength of the brazed joint held at 900 °C for 30 min exceeded 279 ± 13 MPa, equivalent to that of the SiC substrate. Compared to direct brazing of SiC using Si–60Al alloy filler and Si–40Al alloy filler, the strengths were increased by 49% and 94%, respectively. Furthermore, the joints exhibited excellent corrosion resistance, with a flexural strength of 177 ± 11 MPa after 10 h of hydrochloric acid immersion.

IMPORTANCE: The survival benefit of laparoscopic total gastrectomy combined with spleen-preserving splenic hilar lymphadenectomy (LSTG) for locally advanced proximal gastric cancer (APGC) without invasion into the greater curvature remains uncertain. OBJECTIVE: To compare the long-term and short-term efficacy of LSTG (D2 + No. 10 group) and conventional laparoscopic total gastrectomy (D2 group) for patients with APGC that has not invaded the greater curvature. DESIGN, SETTING, AND PARTICIPANTS: In this open-label, prospective randomized clinical trial, a total of 536 patients with clinical stage cT2 to 4a/N0 to 3/M0 APGC without invasion into the greater curvature were enrolled from January 2015 to October 2018. The final follow-up was on October 31, 2021. Data were analyzed from December 2021 to February 2022. INTERVENTIONS: Eligible patients were randomized to the D2 + No. 10 group or the D2 group. MAIN OUTCOMES AND MEASURES: The primary outcome was 3-year disease-free survival (DFS). The secondary outcomes were 3-year overall survival (OS) and morbidity and mortality within 30 days after surgery. RESULTS: Of 526 included patients, 392 (74.5%) were men, and the mean (SD) age was 60.6 (9.6) years. A total of 263 patients were included in the D2 + No. 10 group, and 263 were included in the D2 group. The 3-year DFS was 70.3% (95% CI, 64.8-75.8) for the D2 + No. 10 group and 64.3% (95% CI, 58.4-70.2; P = .11) for the D2 group, and the 3-year OS in the D2 + No. 10 group was better than that in the D2 group (75.7% [95% CI, 70.6-80.8] vs 66.5% [95% CI, 60.8-72.2]; P = .02). Multivariate analysis revealed that splenic hilar lymphadenectomy was not an independent protective factor for DFS (hazard ratio [HR], 0.86; 95% CI, 0.63-1.16) or OS (HR, 0.81; 95% CI, 0.59-1.12). Stratification analysis showed that patients with advanced posterior gastric cancer in the D2 + No. 10 group had better 3-year DFS (92.9% vs 39.3%; P < .001) and OS (92.9% vs 42.9%; P < .001) than those in the D2 group. Multivariate analysis confirmed that patients with advanced posterior gastric cancer could have the survival benefit from No. 10 lymph node dissection (DFS: HR, 0.10; 95% CI, 0.02-0.46; OS: HR, 0.12; 95% CI, 0.03-0.52). CONCLUSIONS AND RELEVANCE: Although LSTG could not significantly improve the 3-year DFS of patients with APGC without invasion into the greater curvature, patients with APGC located posterior gastric wall may benefit from LSTG. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02333721

ObjectiveGastric cancer (GC) ranks fifth in incidence and fourth for mortality worldwide. The response to immune checkpoint blockade (ICB) therapy in GC is heterogeneous due to tumour-intrinsic and acquired immunotherapy resistance. We developed an immunophenotype-based subtyping of human GC based on immune cells infiltration to develop a novel treatment option.DesignA algorithm was developed to reclassify GC into immune inflamed, excluded and desert subtypes. Bioinformatics, human and mouse GC cell lines, syngeneic murine gastric tumour model, and CTLA4 blockade were used to investigate the immunotherapeutic effects by restricting receptor tyrosine kinase (RTK) signalling in immune desert (ICB-resistant) type GC.ResultsOur algorithm restratified subtypes of human GC in public databases and showed that immune desert-type and excluded-type tumours are ICB-resistant compared with immune-inflamed GC. Moreover, epithelial-mesenchymal transition (EMT) signalling was highly enriched in immune desert-type GC, and syngeneic murine tumours exhibiting mesenchymal-like, compared with epithelial-like, properties are T cell-excluded and resistant to CTLA4 blockade. Our analysis further identified a panel of RTKs as potential druggable targets in the immune desert-type GC. Dovitinib, an inhibitor of multiple RTKs, strikingly repressed EMT programming in mesenchymal-like immune desert syngeneic GC models. Dovitinib activated the tumour-intrinsic SNAI1/2-IFN-γ signalling axis and impeded the EMT programme, converting immune desert-type tumours to immune inflamed-type tumours, sensitising these mesenchymal-like ‘cold’ tumours to CTLA4 blockade.ConclusionOur findings identified potential druggable targets relevant to patient groups, especially for refractory immune desert-type/ ‘cold’ GC. Dovitinib, an RTK inhibitor, sensitised desert-type immune-cold GC to CTLA4 blockade by restricting EMT and recruiting T cells.

Black shank disease incited by Phytophthora nicotianaeis one of the most devastating soil-borne diseases of tobacco (Nicotiana tabacumL.). Crop rotation is an effective strategy for the management of this disease. However, the efficacy of rotation with different crops in controlling tobacco black shank remains obscure. In this study, 10 different preceding crops, including rape, wheat, barley, broad bean, pea, garlic, ryegrass, cow vetch, alfalfa, and milk vetch, were selected in fields with an history of severe tobacco black shank. The effectiveness of crop rotation on tobacco black shank disease control was quantitatively determined as amount of Phytophthora nicotianaeusing (1) fluorescence quantitative Polymerase Chain Reaction (qPCR), (2) tobacco leaf disk assays, and (3) soil dilution plating assays. In addition, the bacterial assemblage associated with rhizosphere of different crops was analyzed by Terminal Restriction Fragment Length Polymorphism (T-RFLP). Results showed that ryegrass, garlic, and barley can effectively reduce the levels of P. nicotianaein the soil, with a consequent decrease of both morbidity and disease index. The rhizosphere bacterial community assemblages changed depending on the different preceding crops.

Objective: To assess the effect of preoperative sarcopenia on the short-term and long-term outcomes in older patients with locally advanced gastric cancer (LAGC). Methods: Clinicopathological data of older patients with LAGC who underwent radical surgery were retrospectively analyzed. Sarcopenia was defined as a skeletal muscle index of less than 36.4 cm2/m2for men and less than 28.4 cm2/m2for women. Comparing the postoperative complications and survival between sarcopenia and non-sarcopenia groups using multicenter data. Results: A total of 406 older patients with LAGC were included in the analysis, including 145 (35.7%) with sarcopenia and 261 (64.3%) with non-sarcopenia. Multivariate logistic regression analysis showed that sarcopenia was an independent risk factor for postoperative complications with CD grade ≥ II (OR 1.616; P< 0.05). Kaplan–Meier survival curve analysis showed that the 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) in the sarcopenia group were lower than those in the non-sarcopenia group (Pboth < 0.05). Multivariate Cox regression analyses showed that sarcopenia was an independent prognostic factor for 5-year OS and RFS (Pboth < 0.05). The 5-year recurrence rate in the sarcopenia group was 57.2%, which was significantly higher than that in the non-sarcopenia group (46.4%; P= 0.036). Recurrence pattern analysis showed that the incidence of distant metastases in patients with sarcopenia (42.8%) was significantly higher than non-sarcopenia (31.4%; P= 0.022). Conclusion: Sarcopenia serves as a valuable predictor of both short-term and long-term outcomes in older patients with LAGC. Therefore, the significance of assessing preoperative nutritional status and implementing thorough postoperative follow-up for older LAGC patients with sarcopenia should be emphasized.

ABSTRACTAccurate and frequent mapping of transient wetland inundation in the boreal region is critical for monitoring the ecological and societal functions of wetlands. Satellite Synthetic Aperture Radar (SAR) has long been used to map wetlands due to its sensitivity to surface inundation and ability to penetrate clouds, darkness, and certain vegetation canopies. Here, we track boreal wetland inundation by developing a two-step modified decision-tree algorithm implemented in Google Earth Engine using Sentinel-1 C-band SAR and Sentinel-2 Multispectral Instrument (MSI) time-series data as inputs. This approach incorporates temporal as well as spatial characteristics of SAR backscatter and is evaluated for the Peace-Athabasca Delta, Alberta (PAD), and Yukon Flats, Alaska (YF) from May 2017 to October 2019. Within these two boreal study areas, we map spatiotemporal patterns in wetland inundation classes of Open Water (OW), Floating Plants (FP), Emergent Plants (EP), and Flooded Vegetation (FV). Temporal variability, frequency, and maximum extents of transient wetland inundation are quantified. Retrieved inundation estimates are compared with in-situ field mapping obtained during the NASA Arctic-Boreal Vulnerability Experiment (ABoVE), and a multi-temporal Landsat-derived surface water map. Over the 2017–2019 study period, we find that fractional inundation area ranged from 18.0% to 19.0% in the PAD, and from 10.7% to 12.1% in the YF. Transient wetland inundation covered ~595 km2of the PAD, comprising ~9.1% of its landscape, and ~102 km2of the YF, comprising ~3.6%. The implications of these findings for wetland function monitoring, and estimating landscape-scale methane emissions are discussed, together with limitations and uncertainties of our approach. We conclude that time series of Sentinel-1 C-band SAR backscatter, screened with Sentinel-2 MSI optical imagery and validated by field measurements, offer a valuable tool for tracking transient boreal wetland inundation.

Cell wall architecture plays a key role in stalk strength and forage digestibility. Lignin, cellulose, and hemicellulose are the three main components of plant cell walls, and they can impact stalk quality by affecting the structure and strength of the cell wall. To explore cell wall development during secondary cell wall lignification in maize stalks, conventional and conditional genetic mapping were used to identify the dynamic quantitative trait loci (QTLs) of the cell wall components and digestibility traits during five growth stages after silking. Acid detergent lignin (ADL), cellulose (CEL), acid detergent fiber (ADF), neutral detergent fiber (NDF), and in vitrodry matter digestibility (IVDMD) were evaluated in a maize recombinant inbred line (RIL) population. ADL, CEL, ADF, and NDF gradually increased from 10 to 40 days after silking (DAS), and then they decreased. IVDMD initially decreased until 40 DAS, and then it increased slightly. Seventy-two QTLs were identified for the five traits, and each accounted for 3.48–24.04% of the phenotypic variation. Six QTL hotspots were found, and they were localized in the 1.08, 2.04, 2.07, 7.03, 8.05, and 9.03 bins of the maize genome. Within the interval of the pleiotropic QTL identified in bin 1.08 of the maize genome, six genes associated with cell wall component biosynthesis were identified as potential candidate genes for stalk strength as well as cell wall-related traits. In addition, 26 conditional QTLs were detected in the five stages for all of the investigated traits. Twenty-two of the 26 conditional QTLs were found at 30 DAS conditioned using the values of 20 DAS, and at 50 DAS conditioned using the values of 40 DAS. These results indicated that cell wall-related traits are regulated by many genes, which are specifically expressed at different stages after silking. Simultaneous improvements in both forage digestibility and lodging resistance could be achieved by pyramiding multiple beneficial QTL alleles identified in this study.

Objective: There is insufficient evidence to evaluate the long-term outcomes of robotic radical gastrectomy. The aim of this study was to compare the radical results and long-term outcomes of robotic and laparoscopic radical gastrectomy. Methods: We prospectively collected and retrospectively analyzed the general clinicopathological data of gastric cancer patients treated with robotic radical gastrectomy (RG) and laparoscopic radical gastrectomy (LG) from July 2016 to July 2018 at Fujian Medical University Union Hospital. The RG cohort was matched 1:3 with the LG cohort by using propensity score matching (PSM). The primary endpoints of the study were 3-year overall survival (OS) and 3-year relapse-free survival (RFS). Results: The study included 221 patients treated with RG and 1106 patients treated with LG for gastric cancer. After PSM, 211 patients were included in the RG cohort, and 663 patients were included in the LG cohort. The 3-year OS rate was 81.0% in the robotic cohort and 79.3% in the laparoscopic cohort (log-rank test, P= 0.516). The 3-year RFS rate was 78.7% in the robotic cohort and 75.6% in the laparoscopic cohort (log-rank test, P= 0.600). In the subgroup analyses, no significant differences were noted between the RG and LG cohorts in terms of 3-year OS and 3-year RFS (all P> 0.05). The therapeutic value index of each lymph node station dissection in the robotic cohort was comparable to that in the laparoscopic cohort. Conclusion: Robotic radical gastrectomy can achieve radical results and long-term outcomes comparable to laparoscopic surgery, and further multicenter prospective studies can be conducted to assess the clinical efficacy of robotic radical gastrectomy.

To ensure carbon neutrality goal, coal-fired power plants will have to take responsibility of deep peak regulation, which is essential to the development of renewable energy power. The penalty for deep peak-regulating operation of coal-fired power units could be more than 40 g/kW h of the net coal consumption rate (NCCR), which is contracted to the adoption of renewable energy power. Hence, in order to identify promising energy saving directions, a distribution of exergy losses in thermodynamic systems of several typical large coal-fired power units is studied in this work. For reference, systematic investigations into related conventional energy saving technologies are conducted, which consider thermodynamic interactions among the components. As a result, three novel technologies are proposed to minimize the exergy loss of the units on the deep peak-shaving condition. Based on the performed feasibility study of these technologies, it is found that: (1) using novel steam governing method on the part-load conditions offers ∼5.5 g/kW h energy saving potential; (2) in the winter season, reducing the back pressure of a dry cooling unit from 15 to 4 kPa at partial load can reduce the NCCR by ∼15 g/kW h; and (3) adopting the efficient heat-supply technology based on pressure matching would provide a NCCR reduction potential of ∼6.2 g/kW h. These new solutions, due to their energy saving effect, positive environmental impact, and cost-effectiveness, forge a synergetic development path of coal-fired and renewable energy power generations under the carbon neutrality target.

OBJECTIVE--Cyclin-dependent kinase 5 (CDK5) regulatory subunit-associated protein 1-hke 1 has recently been linked to type 2 diabetes by genome-wide association studies. While CDK5 and its regulatory protein p35 are both expressed and display enzymatic activity in pancreatic β-cells, their precise role in the β-cell remains unknown. Because type 2 diabetes is characterized by a deficit in β-cell mass and increased β-cell apoptosis, we investigated the role of CDK5 in β-cell survival. RESEARCH DESIGN AND METHODS--We used INS 832/13 cells, rat islets isolated from wild-type or human islet amyloid polypeptide (h-IAPP) transgenic rats, and pancreatic tissue from rats and humans with and without type 2 diabetes and investigated the effect of CDK5/p35 inhibition (by small interfering RNA or by chemical inhibition) as well as CDK5/p35 over-expression on β-cell vulnerability to apoptosis. RESULTS--CDK5 inhibition led to increased β-cell apoptosis. To identify the mechanisms involved, we examined the phosphorylation state of focal adhesion kinase [(Fak).sup.ser732], a known target of CDK5. Following CDK5 inhibition, the phosphorylation of [Fak.sup.Ser732] decreased with resulting attenuation of phosphatidylinositol 3-kinase (PI3K)/Akt survival pathway. Conversely, CDK5 overexpression increased [Fak.sup.Ser732] phosphorylation and protected β-cells against apoptosis induced by the inhibition of the β-1 integrin signaling pathway. Also, [Fak.sup.Ser732] phosphorylation was less abundant in β-cells in both h-IAPP transgenic rats and humans with type 2 diabetes. CONCLUSIONS--This study shows that by regulating Fak phosphorylation and subsequently PI3K/Akt survival pathway, CDK5 plays a previously unrecognized role in promoting β-cell survival., Genome-wide association studies have identified a variant of the cyclin-dependent kinase 5 (CDK5) regulatory subunit-associated protein 1-like 1 (CDKAL1) to be associated with type 2 diabetes (1-5). CDK5 is a [...]

OBJECTIVE--The islet in type 2 diabetes is characterized by β-cell apoptosis, β-cell endoplasmic reticulum stress, and islet amyloid deposits derived from islet amyloid polypeptide (IAPP). Toxic oligomers of IAPP form intracellularly in β-cells in humans with type 2 diabetes, suggesting impaired clearance of misfolded proteins. In this study, we investigated whether human-IAPP (h-IAPP) disrupts the endoplasmic reticulum-associated degradation/ubiquitin/proteasome system. RESEARCH DESIGN AND METHODS--We used pancreatic tissue from humans with and without type 2 diabetes, isolated islets from h-IAPP transgenic rats, isolated human islets, and INS 832/13 cells transduced with adenoviruses expressing either h-IAPP or a comparable expression of rodent-IAPP. Immunofluorescence and Western blotting were used to detect polyubiquitinated proteins and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) protein levels. Proteasome activity was measured in isolated rat and human islets. UCH-L1 was knocked down by small-interfering RNA in INS 832/13 cells and apoptosis was evaluated. RESULTS--We report accumulation of polyubiquinated proteins and UCH-L1 deficiency in β-cells of humans with type 2 diabetes. These findings were reproduced by expression of oligomeric h-IAPP but not soluble rat-IAPP. Downregulation of UCH-L1 expression and activity to reproduce that caused by h-IAPP in β-cells induced endoplasmic reticulum stress leading to apoptosis. CONCLUSIONS--Our results indicate that defective protein degradation in β-cells in type 2 diabetes can, at least in part, be attributed to misfolded h-IAPP leading to UCH-L1 deficiency, which in turn further compromises β-cell Viability. Diabetes 60: 227-238, 2011, Type 2 diabetes is characterized by a progressive decline in β-cell function in the face of insulin resistance. Although the mechanisms underlying β-cell dysfunction are unknown, it is likely related [...]

The effect of strain rate on the fracture behaviour of Cr18Ni11Ti stainless steel at high temperatures was analysed. The steel was subjected to solid solution treatment at 1050 °C and ageing at 650 °C for 24 h. The high-temperature tensile properties of Cr18Ni11Ti stainless steel were subsequently investigated via high-temperature tensile testing at 650 °C and different strain rates (1.43 × 10–1, 1.43 × 10–2, 1.43 × 10–3, 1.43 × 10–4, and 1.43 × 10–5s−1). The microstructure, precipitated phase, tensile fracture surface, and dislocation of the experimental steel were analysed by scanning electron microscopy, transmission electron microscopy and energy spectrometry. The results show that Cr18Ni11Ti stainless steel is mainly austenite, with a large number of twin crystals, chromium-rich precipitated phase and composite precipitated phases of TiC and AlMgCaO. With decreases in strain rate, the yield strength, ultimate tensile strength, and reduction in area also decrease. When the strain rate is high, obvious necking and ductile fracture occur in the experimental steel. However, when the strain rate is reduced to 1.43 × 10–5s−1, the necking phenomenon is not obvious and intergranular brittle fracture appears. Greater segregation of P and S contents at grain boundaries, or dislocation motion creep and grain-boundary sliding creep, leads to brittle fracture of the steel at lower strain rates of 1.43 × 10–4to 1.43 × 10–5s−1.

Objective: This study aimed to analyze the fungal species of pathogens isolated from patients with superficial mucocutaneous mycosis from May 2007 to December 2018. Methods: A retrospective analysis was carried out to determine the pathogenic fungi isolated from patients with superficial fungal infections in the Medical Mycology Clinical Laboratory, Department of Dermatology and Venereology, Union Hospital, from May 2007 to December 2018. Results: A total of 7639 strains were obtained, belonging to 21 genera and 36 species. They mainly consisted of Candida(3707/7639, 48.53%) and dermatophytes (3594/7639, 47.05%). The specimens were skin scales, nail shavings, secretions on the nail grooves, broken or diseased hair and dandruff, secretions or pseudomembrane of the external genitalia, and the oral mucosa. A total of 7300 patients were enrolled in this study, including 3301 males and 3999 females aged 2 months to 92 years old with a median age of 46.04 years old except for 633 patients whose ages were unknown. Two strains of different species were isolated from each of 339 patients at different body sites. The most frequent species were Trichophyton rubrumcomplex (2906/7639, 38.04%), Candida albicans(2619/7639, 34.28%), and unclassified Candidaspp. Dermatophytes were mostly isolated from glabrous skin (2138/3594, 59.49%), with T. rubrumcomplex being the predominant species. Candidastrains were most commonly isolated from mucosal sites (1979/3707, 53.39%), and C. albicanswas the most prevalent causative agent. Conclusion: The main distribution of pathogenic fungal species isolated from patients with superficial mycosis from 2007 to 2018 in Wuhan, Hubei province and the surrounding areas was that Candidaslightly outnumbered dermatophytes. Among all of the isolated strains, T. rubrumcomplex was the most abundant.

ABSTRACTIn this work, two peak-to-average-power ratio (PAPR) reduction methods based on bit flipping are designed for OFDM signals. Rather than sending side information, error correction codes are used to recover the flipped bits, as well as to protect the transmitted data. The first PAPR reduction method combines hard-decision decoding (HDD) and natural mapping. Taking advantage of the fact that the natural mapping symbol is represented as a linear combination of the included bits, the flipping bits can be selected at low complexity. The concept of compressed sensing is introduced in order to minimize the number of flipping bits and retain most of the code distance for error correction. In the second method, a low-density parity-check (LDPC) code is cascaded as an inner code following the HDD code, and Gray mapping is used. Soft-decision decoding (SDD) is applied to the LDPC code, which significantly improves the data protection capability, then the outer HDD code is able to focus on recovering the flipped bits. The designs proposed in this paper show great flexibility and provide a trade-off between PAPR reduction and the error-correction capability.

Studies have suggested that endoplasmic reticulum stress (ERS) is involved in neurological dysfunction and that electroacupuncture (EA) attenuates neuropathic pain (NP) via undefined pathways. However, the role of ERS in the anterior cingulate cortex (ACC) in NP and the effect of EA on ERS in the ACC have not yet been investigated. In this study, an NP model was established by chronic constriction injury (CCI) of the left sciatic nerve in rats, and mechanical and cold tests were used to evaluate behavioral hyperalgesia. The protein expression and distribution were evaluated using western blotting and immunofluorescence. The results showed that glucose-regulated protein 78 (BIP) and inositol-requiring enzyme 1α (IRE-1α) were co-localized in neurons in the ACC. After CCI, BIP, IRE-1α, and phosphorylation of IRE-1α were upregulated in the ACC. Intra-ACC administration of 4-PBA and Kira-6 attenuated pain hypersensitivity and downregulated phosphorylation of IRE-1α, while intraperitoneal injection of 4-PBA attenuated hyperalgesia and inhibited the activation of P38 and JNK in ACC. In contrast, ERS activation by intraperitoneal injection of tunicamycin induced behavioral hyperalgesia in naive rats. Furthermore, EA attenuated pain hypersensitivity and inhibited the CCI-induced overexpression of BIP and pIRE-1α. Taken together, these results demonstrate that EA attenuates NP by suppressing BIP- and IRE-1α-mediated ERS in the ACC. Our study presents novel evidence that ERS in the ACC is implicated in the development of NP and provides insights into the molecular mechanisms involved in the analgesic effect of EA.

[C24H28N2O3], monoclinic, P121/n, a= 12.8878(5) Å, b= 27.5641(11) Å, c= 13.0517(6) Å, β= 111.908(2)∘, V= 4301.7(3) Å3, Z= 4, Rgt(F) = 0.0576, wRref(F2) = 0.1749, T = 296(2) K.

OBJECTIVE--Endoplasmic reticulum (ER) stress-induced apoptosis may be a common cause of cell attrition in diseases characterized by misfolding and oligomerisation of amyloidogenic proteins. The islet in type 2 diabetes is characterized by islet amyloid derived from islet amyloid polypeptide (IAPP) and increased β-cell apoptosis. We questioned the following: 1) whether IAPP-induced β-cell apoptosis is mediated by ER stress and 2) whether β-cells in type 2 diabetes are characterized by ER stress. RESEARCH DESIGN AND METHODS--The mechanism of IAPP-induced apoptosis was investigated in INS-1 cells and human IAPP (HIP) transgenic rats. ER stress in humans was investigated by β-cell C/EBP homologous protein (CHOP) expression in 7 lean nondiabetic, 12 obese nondiabetic, and 14 obese type 2 diabetic human pancreata obtained at autopsy. To assure specificity for type 2 diabetes, we also examined pancreata from eight cases of type 1 diabetes. RESULTS--IAPP induces β-cell apoptosis by ER stress in INS-1 cells and HIP rats. Perinuclear CHOP was rare in lean nondiabetic (2.6 ± 2.0%) and more frequent in obese nondiabetic (14.6 ± 3.0%) and obese diabetic (18.5 ± 3.6%) pancreata. Nuclear CHOP was not detected in lean nondiabetic and rare in obese nondiabetic (0.08 ± 0.04%) but six times higher (P < 0.01) in obese diabetic (0.49 ± 0.17%) pancreata. In type 1 diabetic pancreata, perinuclear CHOP was rare (2.5 ± 2.3%) and nuclear CHOP not detected. CONCLUSIONS--ER stress is a mechanism by which IAPP induces β-cell apoptosis and is characteristic of β-cells in humans with type 2 diabetes but not type 1 diabetes. These findings are consistent with a role of protein misfolding in β-cell apoptosis in type 2 diabetes. Diabetes 56:2016-2027, 2007, Both type 1 and type 2 diabetes are characterized by deficits in β-cell mass and increased β-cell apoptosis (1-6). The mechanism that initiates p-cell apoptosis in type 1 diabetes is [...]

•Broken fine-grained pyrite and fine-grained arsenopyrite show highest gold content.•Gold mainly exists in Au complex in the form of solid solution (Au+).•Adsorption of Au through voids and/or defects and As content.•Mineralization in extensional environment after the middle-late Triassic subduction.

The influence of trace Y on the microstructure evolution and mechanical properties of Mg100−xYx(x=0.25, 0.75, 1.5, 3, 4, 5, at.%) alloys during solidification process was investigated via molecular dynamics (MD) simulations. The results show that the Mg100−xYxalloys are mainly characterized by a face-centered cubic (FCC) crystal structure; this is different from pure metal Mg, which exhibits a hexagonal close packed (HCP) structure at room temperature. Among these alloys, Mg99.25Y0.75has a larger proportion of FCC cluster structures, with the highest fraction reaching 56.65%. As the content of the Y increases up to 5 at.% (Mg95Y5alloy), the amount of amorphous structures increases. The mechanical properties of the Mg100−xYxalloys are closely related to their microstructures. The Mg99.25Y0.75and Mg97Y3alloys exhibit the highest yield strengths of 1.86 and 1.90 GPa, respectively. The deformation mechanism of the Mg−Y alloys is described at the atomic level, and it is found that a difference in the FCC proportion caused by different Y contents leads to distinct deformation mechanisms.

Background: It remains inconclusive whether laparoscopic gastrectomy (LG) has better long-term outcomes when compared with open gastrectomy (OG) for elderly gastric cancer (EGC). We attempted to explore the influence of the immune prognostic index (IPI) on the prognosis of EGCs treated by LG or OG to identify a population among EGC who may benefit from LG. Methods: We included 1539 EGCs treated with radical gastrectomy from January 2007 to December 2016. Propensity score matching was applied at a ratio of 1:1 to compare the LG and OG groups. The IPI based on dNLR ≥ cut-off value (dNLR) and sLDH ≥ cut-off value (sLDH) was developed, characterizing two groups (IPI = 0, good, 0 factors; IPI = 1, poor, 1 or 2 factors). Results: Of the 528 EGCs (LG: 264 and OG: 264), 271 were in the IPI = 0 group, and 257 were in the IPI = 1 group. In the entire cohort, the IPI = 0 group was associated with good 5-year overall survival (OS) (p= 0.001) and progression-free survival (PFS) (p= 0.003) compared to the IPI = 1 group; no significant differences in 5-year OS and PFS between the LG and OG groups were observed. In the IPI = 1 cohort, there was no significant difference in OS or PFS between the LG and OG groups across all tumor stages. However, in the IPI = 0 cohort, LG was associated with longer OS (p= 0.015) and PFS (p= 0.018) than OG in stage II EGC, but not in stage I or III EGC. Multivariate analysis showed that IPI = 0 was an independent protective factor for stage II EGC receiving LG, but not for those receiving OG. Conclusion: The IPI is related to the long-term prognosis of EGC. Compared with OG, LG may improve the 5-year survival rate of stage II EGC with a good IPI score. This hypothesis needs to be further confirmed by prospective studies.

Background: The oncologic efficacy of laparoscopic versus open surgery for advanced distal gastric cancer (ADGC) beyond 3 years after surgery remain obscure. Methods: A total of 1256 patients with ADGC at two teaching institutions in China from April 2007 to December 2014 were enrolled. The general data of the two groups were identified to enable rigorous estimation of propensity scores. Restricted mean survival time (RMST) and Landmark analysis was used to compare survival. Results: After matching 461 patients each in the open distal gastrectomy (ODG) and laparoscopic distal gastrectomy (LDG) groups, they were included into analysis. The 3- and 5-year overall survival (OS) and disease-free survival were comparable in two groups. RMST-stratified analysis showed that the 3-year RMST of ODG group was similar to that of LDG group in patients with cT4a (− 1.38 years, p= 0.163) or with cT4a and tumor size > 5 cm, whereas the 5-year RMST had significant differences between groups in cT4a patients(− 8.36 years, P= 0.005) or cT4a and tumor size > 5 cm patients(4.67 years, P= 0.042). In patients with cT4a and tumors > 5 cm, the number of peritoneal recurrences was significantly fewer in the ODG group than in the LDG group (4 vs. 17, P= 0.033), and the peritoneal recurrence time and multiple-site recurrence time were both later in the ODG group. Conclusion: By reducing recurrence, ODG achieves a better survival for GC patients with serous infiltration and tumors larger than 5 cm beyond 3 years after surgery. The present findings can serve as a reference for surgical options and the setting of follow-up time point for clinical studies.

We have demonstrated that CDK5RAP3 exerts a tumour suppressor effect in gastric cancer, but its role in regulating tumour-associated macrophages (TAMs) has not yet been reported. Here, we show that CDK5RAP3 is related to the infiltration and polarization of macrophages. It inhibits the polarization of TAMs to M2 macrophages and promotes the polarization of the M1 phenotype. CDK5RAP3 reduces the recruitment of circulating monocytes to infiltrate tumour tissue by inhibiting the CCL2/CCR2 axis in gastric cancer. Blocking CCR2 reduces the growth of xenograft tumours and the infiltration of monocytes. CDK5RAP3 inhibits the nuclear transcription of NF-κB, thereby reducing the secretion of the cytokines IL4 and IL10 and blocking the polarization of M2 macrophages. In addition, the absence of CDK5RAP3 in gastric cancer cells allows macrophages to secrete more MMP2 to promote the epithelial-mesenchymal transition (EMT) process of gastric cancer cells, thereby enhancing the invasion and migration ability. Our results imply that CDK5RAP3 may be involved in the regulation of immune activity in the tumour microenvironment and is expected to become a potential immunotherapy target for gastric cancer.

Microplastic pollution has become an environmental issue of great concern owing to the persistence of microplastics and their potential adverse effects on biota. The Yangtze River is the longest river in China and the third-longest river in the world, and the microplastics in this river will affect the health of a large population living along with it. To ensure the survival safety of people, it is essential to plan ahead and investigate in advance in order to understand the microplastic pollution in the river and work out countermeasures. This paper reviews the literature concerning the microplastic pollution in the Yangtze River basin and analyzes the abundance, shapes, colors, and composition of microplastics in the water bodies and sediments in the trunk stream and main lakes of the Yangtze River. The results are as follows. Compared to other river basins in China and abroad, the microplastics in the Yangtze River basin have a moderate abundance and high spatial heterogeneity. Owing to the barrier effect of the Three Gorges Dam on microplastics, the abundance of microplastics in the Three Gorges Reservoir is generally an order of magnitude higher than that in other sections of the river. Most microplastics in the water bodies and sediments are less than 1 mm in size and are transparent and colorful. In terms of shapes, they are dominated by fibers, followed by fragments and films. In terms of composition, the microplastics in the source region of the Yangtze River are mainly composed of nylon and polyethylene, while the microplastics in the surface water from the lower reaches of the Jinsha River to the Yangtze River estuary are dominated by polypropylene and polyethylene. The microplastics are primarily derived from the secondary microplastics in the environment, and relatively intensive human activities increase the abundance of microplastics. These results serve as bases for understanding and preventing microplastic pollution in the Yangtze River.

Objective: To investigate the effect of intraoperative lymph node (LN) dissection and postoperative adjuvant chemotherapy on the overall survival (OS) of gastric cancer (GC) patients and their reciprocity. Methods: LN noncompliance was defined as the absence of more than one LN station, as described in the protocol for D2 lymphadenectomy in the Japanese Gastric Cancer Association. The definition of adjuvant chemotherapy (AC) noncompliance was that the chemotherapy planned dose does not meet the requirements. Results: Kaplan–Meier survival curves showed that the OS of patients with major LN noncompliance was significantly lower than that of patients with nonmajor LN noncompliance, and the OS of AC noncompliance patients was significantly lower than that of AC compliance patients. If there was nonmajor LN noncompliance during surgery, the OS of patients with AC compliance was significantly higher than that of patients with AC noncompliance (P= 0.035). In the case of major LN noncompliance during surgery, there was no statistically significant difference in OS between those with AC compliance and those with AC noncompliance (P = 0.682). Multivariate Cox regression analysis including AC noncompliance indicated that major LN noncompliance was an independent prognostic factor for poor OS (P= 0.012), while AC noncompliance was not an independent prognostic factor for OS (P= 0.609). Conclusion: Adequate lymph node dissection and adjuvant chemotherapy are both key steps to improve the awful prognosis of GC patients. Adjuvant chemotherapy may fail to remedy the poor prognosis caused by major LN noncompliance.

Background: Robotic surgery may be advantageous for complex surgery. We aimed to compare the intraoperative and postoperative short-term outcomes of spleen-preserving splenic hilar lymphadenectomy (SPSHL) during robotic and laparoscopic total gastrectomy. Methods: From July 2016 to December 2020, the clinicopathological data of 115 patients who underwent robotic total gastrectomy combined with robotic SPSHL (RSPSHL) and 697 patients who underwent laparoscopic total gastrectomy combined with laparoscopic SPSHL (LSPSHL) were retrospectively analyzed. A 1:2 ratio propensity score matching (PSM) was used to balance the differences between the two groups to compare their outcomes. The Generic Error Rating Tool was used to evaluate the technical performance. Results: After PSM, the baseline preoperative characteristics of the 115 patients in the RSPSHL and 230 patients in the LSPSHL groups were balanced. The dissection time of the region of the splenic artery trunk (5.4 ± 1.9 min vs. 7.8 ± 3.6 min, P&lt; 0.001), the estimated blood loss during SPSHL (9.6 ± 4.8 ml vs. 14.9 ± 7.8 ml, P&lt; 0.001), and the average number of intraoperative technical errors during SPSHL (15.1 ± 3.4 times/case vs. 20.7 ± 4.3 times/case, P&lt; 0.001) were significantly lower in the RSPSHL group than in the LSPSHL group. The RSPSHL group showed higher dissection rates of No. 10 (78.3% vs. 70.0%, P= 0.104) and No. 11d (54.8% vs. 40.4%, P= 0.012) lymph nodes and significantly improved postoperative recovery results in terms of times to ambulation, first flatus, and first intake (P&lt; 0.05). The splenectomy rates of the two groups were similar (1.7% vs. 0.4%, P= 0.539), and there was no significant difference in morbidity and mortality within postoperative 30 days (13.0% vs. 15.2%, P= 0.589). Conclusion: Compared to LSPSHL, RSPSHL has more advantages in terms of surgical qualities and postoperative recovery process with similar morbidity and mortality. For complex SPSHL, robotic surgery may be a better choice.

Background: Due to lacking evidence for confirming the efficacy of performing laparoscopic surgery for locally advanced gastric cancer (LAGC). Therefore, this study aimed to compare the static and dynamic failure patterns after laparoscopic gastrectomy (LG) and open gastrectomy (OG) in LAGC. Methods: A total of 1792 LAGC patients who underwent radical resection between January 2010 and January 2017 were divided into the LG group (n= 1557) and the OG group (n= 235). Propensity score matching was performed to balance the two groups. Dynamic hazard rates of failure were calculated using the hazard function. Early and late failure were defined as failure occurring before and after 2 years since surgery, respectively. Results: A total of 1175 patients with LAGC were included after matching (LG group, n= 940; OG, n= 235). The failure rate of the whole cohort was 43.2% (508/1175), accounting for 41.4% (389/940) and 50.6% (119/235) in the LG and OG groups, respectively. Although the two groups showed no significant differences in failure rate for any failure type, landmark analysis showed a lower early distant recurrence rate in the stage IIa–IIIb subgroup of the LG group (OG versus LG: 30.3% versus 21.1%, P= 0.004). The dynamic hazard rate peaked at 9.4 months (peak rate = 0.0186) before gradually declining. In stage IIa–IIIb patients, the hazard rate of the OG group remained significantly higher than that of the LG group within the first 2 years in terms of distant recurrence (peak rate: OG versus LG, 0.0091 versus 0.0055). Conclusion: Given the differences in early failure between LG and OG, more intensive surveillance for distant recurrence within the first 2 years should be considered for patients with stage IIa–IIIb after OG.

Traditional bridge inspection methods mostly rely on the experience and expertise of inspectors in visual detection of cracks. Such visual inspection methods are not only time consuming but also could be affected by subjective judgment of inspectors and lack a unified inspection standard. To overcome the shortcomings of visual inspection, this study investigates the feasibilities of using an unmanned aerial vehicle (UAV) combined with laser projectors to measure surface cracks. All related parameters of the laser projectors that are fixed on the UAV are calibrated first in the laboratory. Then, the UAV with the laser projectors is used to capture images of surface cracks. The images from the UAV can be transformed to orthoimages using the laser projectors’ parameters and the image processing technology. Next, surface cracks in the orthoimages are automatically identified by a crack identification algorithm. Finally, the characteristics of surface cracks are evaluated by the image-based measurement technologies. To verify the accuracy of the proposed image-based measurement system (UAV with laser projectors), seven artificial cracks with different widths are measured using the proposed measurement system and the point cloud method (UAV with the global navigation satellite system) under different measurement distances. The test results demonstrate that while the distance between the UAV and the artificial crack is within 150 cm, the proposed image-based measurement system is able to measure crack widths more accurately than the GNSS point cloud method. In addition, the proposed image-based measurement system can automatically identify surface cracks and measure crack widths from UAV-captured images without manual measurements.

Measurement of four dNTP pools is important for investigating metabolism, genome stability, and drug action. In this report, we developed a two-step method for quantitating dNTPs by the combination of rolling circle amplification (RCA) and quantitative polymerase chain reaction (qPCR). We used CircLigase to generate a single-strand DNA in circular monomeric configuration, which was then used for the first step of RCA reaction that contained three dNTPs in excess for quantification of one dNTP at limiting levels. The second step is the amplification of RCA products by qPCR, in which one primer was designed to be completely annealed with the polymeric ssDNA product but not the monomeric template DNA. Using 1 amol of the template in the assay, each dNTP from 0.02 to 2.5 pmol gave a linearity with r2> 0.99, and the quantification was not affected by the presence of rNTPs. We further found that the preparation of biological samples for the RCA reaction required methanol and chloroform extraction. The method was so sensitive that 1 × 104cells were sufficient for dNTP quantification with the results similar to those determined by a radio-isotope method using 2 × 105cells. Thus, the RCA/qPCR method is convenient, cost-effective, and highly sensitive for dNTP quantification.

Several days were shaved off the time it took to drill each of 10 subsea wells for the Liuhua 11-1 development project in the South China Sea by using a highly efficient batch drilling program. Being developed by operator Amoco Orient Petroleum Co, along with partners China Offshore Oil Nanhai East Corp and Kerr-McGee China Petroleum Ltd, the Liuhua project has been thoroughly tested since it was discovered in 1987., The efficiency of batch drilling operations and the appropriate use of technology, teamwork, and thorough planning helped cut several days off tile time to drill each of 10 subsea wells [...]

We see the world with two eyes. Binocular vision provides more ample information through interocular interaction. Previous studies have shown that aging impairs a variety of visual functions, but how aging affects binocular vision is still unclear. In this study, we measured three typical binocular functions—binocular combination, binocular rivalry, and stereo vision—to investigate aging‐related effects on binocular vision in a relatively large sample (48 younger adults and 27 older adults) with normal or corrected‐to‐normal distance vision and no ophthalmological and mental diseases. We found that there were no consistent aging‐related declines in binocular vision, with the worst effect on alternation frequency in binocular rivalry and no effect on binocular phase combination and stereo vision tested by Titmus. In addition, aging changed the correlation pattern among some of these binocular functions. These results reflected (at least partially) different aging‐related mechanism(s) in binocular vision.