Outcomes of Robotic Versus Laparoscopic Pancreatoduodenectomy Following Learning Curves of Surgeons: A Multicenter Study on 2255 Patients.

OBJECTIVE: This study aimed to compare robotic pancreatoduodenectomy (RPD) with laparoscopic pancreatoduodenectomy (LPD) in operative and oncologic outcomes. BACKGROUND: Previous studies comparing RPD with LPD have only been carried out in small, single-center studies with variable quality. METHODS: Consecutive patients from nine centers in China who underwent RPD or LPD between 2015 and 2022 were included. A 1:1 propensity score matching (PSM) was used to minimize bias. RESULTS: Of the 2,255 patients, 1158 underwent RPD and 1097 underwent LPD. Following PSM, 1006 patients were enrolled in each group. The RPD group had significantly shorter operative time (270.0 vs. 305.0 minutes, P<0.001), lower intraoperative blood transfusion rate (5.9% vs. 12.0%, P<0.001), lower conversion rate (3.8% vs. 6.7%, P=0.004), and higher vascular reconstruction rate (7.9% vs. 5.6%, P=0.040) than the LPD group. There were no significant differences in estimated blood loss, postoperative length of stay, perioperative complications, and 90-day mortality. Patients who underwent vascular reconstruction had similar outcomes between the two groups, although they had significantly lower estimated blood loss (300.0 vs. 360.0 mL; P=0.021) in the RPD group. Subgroup analysis on pancreatic ductal adenocarcinoma (PDAC) found no significant differences between the two groups in median recurrence-free survival (14.3 vs. 15.3 mo, P=0.573) and overall survival (24.1 vs. 23.7 mo, P=0.710). CONCLUSIONS: In experienced hands, both RPD and LPD are safe and feasible procedures with similar surgical outcomes. RPD had the perioperative advantage over LPD especially in vascular reconstruction. For PDAC patients, RPD resulted in similar oncological and survival outcomes as LPD.

Perioperative and Oncological Outcomes of Robotic Versus Open Pancreaticoduodenectomy in Low-Risk Surgical Candidates: A Multicenter Propensity Score-Matched Study.

OBJECTIVES: This study aimed to perform a multicenter comparison between robotic pancreaticoduodenectomy (RPD) and open pancreaticoduodenectomy (OPD). BACKGROUND: Previous comparisons of RPD versus OPD have only been carried out in small, single-center studies of variable quality. METHODS: Consecutive patients who underwent RPD (n = 1032) or OPD (n = 1154) at 7 centers in China between July 2012 and July 2020 were included. A 1:1 propensity score matching (PSM) was performed. RESULTS: After PSM, 982 patients in each group were enrolled. The RPD group had significantly lower estimated blood loss (EBL) (190.0 vs 260.0 mL; P < 0.001), and a shorter postoperative 1length of hospital stay (LOS) (12.0 (9.0-16.0) days vs 14.5 (11.0-19.0) days; P < 0.001) than the OPD group. There were no significant differences in operative time, major morbidity including clinically relevant postoperative pancreatic fistula (CR-POPF), bile leakage, delayed gastric emptying, postoperative pancreatectomy hemorrhage (PPH), reoperation, readmission or 90-day mortality rates. Multivariable analysis showed R0 resection, CR-POPF, PPH and reoperation to be independent risk factors for 90-day mortality. Subgroup analysis on patients with pancreatic ductal adenocarcinoma (PDAC) (n = 326 in each subgroup) showed RPD had advantages over OPD in EBL and postoperative LOS. There were no significant differences in median disease-free survival (15.2 vs 14.3 months, P = 0.94) or median overall survival (24.2 vs 24.1 months, P = 0.88) between the 2 subgroups. CONCLUSIONS: RPD was comparable to OPD in feasibility and safety. For patients with PDAC, RPD resulted in similar oncologic and survival outcomes as OPD.

UAV-based multi-sensor data fusion and machine learning algorithm for yield prediction in wheat.

Early prediction of grain yield helps scientists to make better breeding decisions for wheat. Use of machine learning (ML) methods for fusion of unmanned aerial vehicle (UAV)-based multi-sensor data can improve the prediction accuracy of crop yield. For this, five ML algorithms including Cubist, support vector machine (SVM), deep neural network (DNN), ridge regression (RR) and random forest (RF) were used for multi-sensor data fusion and ensemble learning for grain yield prediction in wheat. A set of thirty wheat cultivars and breeding lines were grown under three irrigation treatments i.e., light, moderate and high irrigation treatments to evaluate the yield prediction capabilities of a low-cost multi-sensor (RGB, multi-spectral and thermal infrared) UAV platform. Multi-sensor data fusion-based yield prediction showed higher accuracy compared to individual-sensor data in each ML model. The coefficient of determination (R 2) values for Cubist, SVM, DNN and RR models regarding grain yield prediction were observed from 0.527 to 0.670. Moreover, the results of ensemble learning through integrating the above models illustrated further increase in accuracy. The predictions of ensemble learning showed high R 2 values up to 0.692, which was higher as compared to individual ML models across the multi-sensor data. Root mean square error (RMSE), residual prediction deviation (RPD) and ratio of prediction performance to inter-quartile range (RPIQ) were calculated to be 0.916 t ha-1, 1.771 and 2.602, respectively. The results proved that low altitude UAV-based multi-sensor data can be used for early grain yield prediction using data fusion and an ensemble learning framework with high accuracy. This high-throughput phenotyping approach is valuable for improving the efficiency of selection in large breeding activities. Supplementary Information: The online version contains supplementary material available at 10.1007/s11119-022-09938-8.

Centromeric protein K (CENPK) promotes gastric cancer proliferation and migration via interacting with XRCC5.

BACKGROUND: CENPK is a novel oncogene which is aberrantly expression in some malignant tumors. However, the role and mechanisms of CENPK in gastric cancer have not been explored. METHODS: In this study, we use RT-PCR and IHC to study CENPK expression in gastric cancer cells and tissues. In addition, we constructed the two kinds of CENPK siRNA lentivirus to knock down CENPK. Then, we use High content living cell imaging System, Cell Counting Kit-8, colony formation, wound healing and Transwell assays to demonstrate the function of CENPK on gastric cancer cells AGS and MKN45. Meanwhile, we use flow cytometry assay to study CENPK function on gastric cancer cell apoptosis and cell cycle arrest. Subcutaneous tumorigenesis in nude mice was also performed to confirm CENPK function on gastric cancer. Finally, we use Co-IP, LC-MS and function rescue assay to study the downstream interaction molecular of CENPK. RESULTS: We demonstrated that CENPK expression were up-regulated in GC cell lines. Poor differentiation and III-IV stage had more percentages of high CENPK expression. Knocking down CENPK could significantly suppress GC cells proliferation, migration and invasion, and induce GC cells apoptosis and G1/S phase transition arrest. Subcutaneous tumorigenesis confirmed the tumor-promoting effects of CENPK in vivo. Remarkably, we found for the first time that XRCC5 might be interacted with CENPK through Co-IP, LC-MS and rescue study. CONCLUSION: CENPK promotes GC cell proliferation and migration via interacting with XRCC5 and may be a novel prognostic factor or therapeutic target for CENPK.

Activation of the G Protein-Coupled Estrogen Receptor Prevented the Development of Acute Colitis by Protecting the Crypt Cell.

G protein-coupled estrogen receptor (GPER) might be involved in ulcerative colitis (UC), but the direct effect of GPER on UC is still unclear. We used male C57BL/6 mice to establish the acute colitis model with administration of dextran sulfate sodium and explored the effect of GPER on acute colitis and its possible mechanism. The selective GPER agonist G-1 inhibited weight loss and colon shortening and decreased the disease activity index for colitis and histologic damage in mice with colitis. All of these effects were prevented by a selective GPER blocker. G-1 administration prevented the dysfunction of tight junction protein expression and goblet cells in colitis model and thus inhibited the increase of mucosal permeability in colitis-suffering mice significantly. GPER activation reduced expression of glucose-regulating peptide-78 and anti-CCAAT/enhancer-binding protein homologous protein and attenuated the three arms of the unfolded protein response in colitis. G-1 therapy inhibited the increase of cleavage caspase-3- and TUNEL-positive cells in colonic crypts in the colitis model, increased the number of Ki67- and bromodeoxyuridine-positive cells in crypts, and reversed the decrease of cyclin D1 and cyclin B1 expression in colitis, indicating its protective effect on crypt cells. In cultured CCD841 cells, G-1 treatment fought against cell injury induced by endoplasmic reticulum stress. These findings demonstrate that GPER activation prevents colitis by protecting the colonic crypt cells, which are associated with inhibition of endoplasmic reticulum stress. SIGNIFICANCE STATEMENT: We demonstrate that G protein-coupled estrogen receptor (GPER) activation prevents dextran sulfate sodium-induced acute colitis by protecting the crypt cells, showing that it inhibited the crypt cell apoptosis and protected proliferation of crypt cells, which resulted in protection of the intestinal mucosal barrier. This protective effect was achieved (at least in part) by inhibiting endoplasmic reticulum stress. Mucosal healing is regarded as a key therapeutic target for colitis, and GPER is expected to become a new therapeutic target for colitis.

Estimating the contribution of plant traits to light partitioning in simultaneous maize/soybean intercropping.

Spatial configuration and plant phenotypic plasticity contribute to increased light capture in relay intercropping, but there is little information on whether these factors also increase light capture in simultaneous intercropping. We developed and validated a three-dimensional functional-structural plant model to simulate light capture in maize and soybean sole crops and intercrop scenarios, using species traits observed in sole crops and intercrops. The intercrop maize phenotype had 2% greater light capture than the sole crop phenotype in a pure stand. The soybean intercrop phenotype had 5-10% lower light capture than the sole crop phenotype in a pure stand. The intercrop configuration increased the light capture of maize by 29% and reduced the light capture of soybean by 42%, compared with the light capture expected from sole crops. However, intercrop configuration only marginally affected total light capture by the intercrop system (+1%). Testing of individual soybean plant traits revealed that plasticity in leaf dimensions was the main reason for differences in light capture by soybean in simulated sole crops and intercrops. The results of this study illustrate a major shift of light capture from shorter species (soybean) to the taller component (maize) in a simultaneous strip intercrop. Plastic plant traits modulate this overall effect, but only marginally.

Retrospective study of aflibercept in combination therapy for high-risk proliferative diabetic retinopathy and diabetic maculopathy.

PURPOSE: To evaluate whether anti-vascular endothelial growth factor (VEGF) therapy combined with panretinal photocoagulation could reverse diabetic retinopathy (DR). METHOD: Fifty-two patients (72 eyes) with high-risk proliferative DR who were diagnosed and treated from June 2018 to May 2019 were divided into the laser group (16 cases, 32 eyes) and combination group (36 cases, 40 eyes) according to a review of the medical records. RESULTS: Within-group comparison: There were no significant differences in best-corrected visual acuity (BCVA), central foveal thickness (CFT), and microaneurysms in the laser group before and after treatment, but there were statistically significant improvements in the combination group. After the treatment, the BCVA of the patients in the combination group was 0.44 ± 0.17, which was significantly better than 0.70 ± 0.18 before treatment; the CFT after treatment was 266.51 ± 33.28 µm, which was significantly lower than 382.37 ± 54.03 µm at baseline; the MA after treatment was 56.12 ± 23.29, which was significantly lower than 121.44 ± 40.35. There was a statistically significant decrease in hard exudates area in both two groups before and after treatment. Comparison between groups: The difference in BCVA, CFT, MA and between the two groups was statistically significant (all P < 0.05), and the area of retinal neovascularization between the two groups was no significant difference, but decreased more rapidly in the combination group than that in the laser group. CONCLUSION: Using intravitreal injection of anti-VEGF drugs combined with panretinal photocoagulation to treat DR might morphologically and functionally reverse retinal changes caused by diabetes mellitus.

Quantification of light interception within image-based 3-D reconstruction of sole and intercropped canopies over the entire growth season.

BACKGROUND AND AIMS: Light interception is closely related to canopy architecture. Few studies based on multi-view photography have been conducted in a field environment, particularly studies that link 3-D plant architecture with a radiation model to quantify the dynamic canopy light interception. In this study, we combined realistic 3-D plant architecture with a radiation model to quantify and evaluate the effect of differences in planting patterns and row orientations on canopy light interception. METHODS: The 3-D architectures of maize and soybean plants were reconstructed for sole crops and intercrops based on multi-view images obtained at five growth dates in the field. We evaluated the accuracy of the calculated leaf length, maximum leaf width, plant height and leaf area according to the measured data. The light distribution within the 3-D plant canopy was calculated with a 3-D radiation model. Finally, we evaluated canopy light interception in different row orientations. KEY RESULTS: There was good agreement between the measured and calculated phenotypic traits, with an R2 >0.97. The light distribution was more uniform for intercropped maize and more concentrated for sole maize. At the maize silking stage, 85 % of radiation was intercepted by approx. 55 % of the upper canopy region for maize and by approx. 33 % of the upper canopy region for soybean. There was no significant difference in daily light interception between the different row orientations for the entire intercropping and sole systems. However, for intercropped maize, near east-west orientations showed approx. 19 % higher daily light interception than near south-north orientations. For intercropped soybean, daily light interception showed the opposite trend. It was approx. 49 % higher for near south-north orientations than for near east-west orientations. CONCLUSIONS: The accurate reconstruction of 3-D plants grown in the field based on multi-view images provides the possibility for high-throughput 3-D phenotyping in the field and allows a better understanding of the relationship between canopy architecture and the light environment.

Estimation of maize plant height and leaf area index dynamics using an unmanned aerial vehicle with oblique and nadir photography.

BACKGROUND AND AIMS: High-throughput phenotyping is a limitation in plant genetics and breeding due to large-scale experiments in the field. Unmanned aerial vehicles (UAVs) can help to extract plant phenotypic traits rapidly and non-destructively with high efficiency. The general aim of this study is to estimate the dynamic plant height and leaf area index (LAI) by nadir and oblique photography with a UAV, and to compare the integrity of the established three-dimensional (3-D) canopy by these two methods. METHODS: Images were captured by a high-resolution digital RGB camera mounted on a UAV at five stages with nadir and oblique photography, and processed by Agisoft Metashape to generate point clouds, orthomosaic maps and digital surface models. Individual plots were segmented according to their positions in the experimental design layout. The plant height of each inbred line was calculated automatically by a reference ground method. The LAI was calculated by the 3-D voxel method. The reconstructed canopy was sliced into different layers to compare leaf area density obtained from oblique and nadir photography. KEY RESULTS: Good agreements were found for plant height between nadir photography, oblique photography and manual measurement during the whole growing season. The estimated LAI by oblique photography correlated better with measured LAI (slope = 0.87, R2 = 0.67), compared with that of nadir photography (slope = 0.74, R2 = 0.56). The total number of point clouds obtained by oblique photography was about 2.7-3.1 times than those by nadir photography. Leaf area density calculated by nadir photography was much less than that obtained by oblique photography, especially near the plant base. CONCLUSIONS: Plant height and LAI can be extracted automatically and efficiently by both photography methods. Oblique photography can provide intensive point clouds and relatively complete canopy information at low cost. The reconstructed 3-D profile of the plant canopy can be easily recognized by oblique photography.

Can T-tube drainage be replaced by primary suture technique in laparoscopic common bile duct exploration? A meta-analysis of randomized controlled trials.

BACKGROUND: Although laparoscopic common bile duct exploration (LCBDE) is considered the best treatment and has the advantages of being minimally invasive for common bile duct (CBD) stones, the choice of T-tube drainage (TTD) or primary duct closure (PDC) after LCBDE is still controversial. Therefore, the aim of the study was to compare the superiority of PDC versus TTD after LCBDE for choledocholithiasis. METHODS: All potential studies which compare the surgical effects between PDC with TTD were electronically searched for in PubMed, Web of Science, and the Cochrane library databases up to November 2019. Data synthesis and statistical analysis were carried out using RevMan 5.3 software. RESULTS: In total, six randomized controlled trials with 604 patients (307 in the PDC group and 297 in the TTD group) were included in the current meta-analysis. As compared with the TTD group, the pooled data showed that PDC group had shorter operating time (WMD = -24.30; 95% CI = -27.02 to -21.59; p < 0.00001; I2 = 0%; p < 0.88), less medical expenditure (WMD = -2255.73; 95% CI = -3330.59 to -1180.86; p < 0.0001; I2 = 96%; p < 0.00001), shorter postoperative hospital stay (OR = -2.88; 95% CI = -3.22 to -2.54; p < 0.00001; I2 = 60%; p < 0.03), and lower postoperative complications (OR = 0.49; 95% CI = 0.31 to 0.78; p = 0.77; I2 = 0%; p = 0.003). There were no significant differences between the two groups concerning bile leakage (OR = 0.74; 95% CI = 0.36 to 1.53; p = 0.42; I2 = 0%; p = 0.90) and retained stones (OR = 0.96; 95% CI = 0.36 to 2.52; p < 0.93; I2 = 0%; p < 0.66). CONCLUSIONS: LCBDE with PDC should be performed as a priority alternative compared with TTD for choledocholithiasis.

Treatment of Superficial Incision Dehiscence after Abdominal Surgery by Z-Plasty: A Retrospective Case Series.

OBJECTIVE: To explore the treatment of superficial incision dehiscence after abdominal surgery by Z-plasty combined with negative-pressure wound therapy. METHODS: A retrospective study was performed on seven patients with superficial abdominal incision dehiscence from October 2018 to February 2019. All patients were given systemic antibiotics and nutrition support. During the first stage, surgical debridement with negative-pressure wound therapy was performed. Local Z-plasty was performed in the second stage. RESULTS: The incision healed well in all patients, and no infection or necrosis occurred in the flaps. During the follow-up of 7.3 months (range, 5-10 months), no incision rupture or redehiscence occurred. CONCLUSIONS: Surgical debridement, negative-pressure wound therapy, and Z-plasty can be used to treat superficial abdominal incision dehiscence and achieve good therapeutic effect and prognosis. Z-plasty can be used as an alternative to direct suture of incisions because of its simplicity and excellent results.

[Evaluating the causal relationship between hip circumference and coronary heart disease: a Mendelian randomization study].

OBJECTIVE: To test the causal effect of hip circumference adjusted for body mass index(HCadjBMI) and coronary heart disease(CHD) using a Mendelian randomization analysis. METHODS: Based on genome-wide association study, the associations between the genetic instruments(IVs) and HCadjBMI were obtained from the GIANT consortium(n=211 114, European), the associations between IVs and CHD were derided from CARDIoGRAM consortium(n=86 995, European). The inverse-variance weighted method was used to estimate a pooled OR for the effect of a 1 cm higher HCadjBMI on CHD. Evidence of directional pleiotropy averaged across all variants was sought using MR-Egger regression. RESULTS: A total of 70 genetic variants that reached genome-wide significance and independent of each other were identified as IVs. A combined genetic variants expected to confer a lifetime exposure of per SD higher HCadjBMI was associated with a lower risk of CHD(OR=0. 831, 95%CI 0. 730-0. 946). MR-Egger regression intercept suggested that directional pleiotropy was unlikely to be biasing the result(intercept-0. 0012, P=0. 875). There was no specific single nucleotide polymorphism(SNP) detected by "leave one out" analysis. CONCLUSION: A genetic predisposition to higher HCadjBMI was associated with lower risk of CHD.

Coupling individual kernel-filling processes with source-sink interactions into GREENLAB-Maize.

Background and Aims: Failure to account for the variation of kernel growth in a cereal crop simulation model may cause serious deviations in the estimates of crop yield. The goal of this research was to revise the GREENLAB-Maize model to incorporate source- and sink-limited allocation approaches to simulate the dry matter accumulation of individual kernels of an ear (GREENLAB-Maize-Kernel). Methods: The model used potential individual kernel growth rates to characterize the individual potential sink demand. The remobilization of non-structural carbohydrates from reserve organs to kernels was also incorporated. Two years of field experiments were conducted to determine the model parameter values and to evaluate the model using two maize hybrids with different plant densities and pollination treatments. Detailed observations were made on the dimensions and dry weights of individual kernels and other above-ground plant organs throughout the seasons. Key Results: Three basic traits characterizing an individual kernel were compared on simulated and measured individual kernels: (1) final kernel size; (2) kernel growth rate; and (3) duration of kernel filling. Simulations of individual kernel growth closely corresponded to experimental data. The model was able to reproduce the observed dry weight of plant organs well. Then, the source-sink dynamics and the remobilization of carbohydrates for kernel growth were quantified to show that remobilization processes accompanied source-sink dynamics during the kernel-filling process. Conclusions: We conclude that the model may be used to explore options for optimizing plant kernel yield by matching maize management to the environment, taking into account responses at the level of individual kernels.

Image-based dynamic quantification and high-accuracy 3D evaluation of canopy structure of plant populations.

Background and Aims: Global agriculture is facing the challenge of a phenotyping bottleneck due to large-scale screening/breeding experiments with improved breeds. Phenotypic analysis with high-throughput, high-accuracy and low-cost technologies has therefore become urgent. Recent advances in image-based 3D reconstruction offer the opportunity of high-throughput phenotyping. The main aim of this study was to quantify and evaluate the canopy structure of plant populations in two and three dimensions based on the multi-view stereo (MVS) approach, and to monitor plant growth and development from seedling stage to fruiting stage. Methods: Multi-view images of flat-leaf cucumber, small-leaf pepper and curly-leaf eggplant were obtained by moving a camera around the plant canopy. Three-dimensional point clouds were reconstructed from images based on the MVS approach and were then converted into surfaces with triangular facets. Phenotypic parameters, including leaf length, leaf width, leaf area, plant height and maximum canopy width, were calculated from reconstructed surfaces. Accurate evaluation in 2D and 3D for individual leaves was performed by comparing reconstructed phenotypic parameters with referenced values and by calculating the Hausdorff distance, i.e. the mean distance between two surfaces. Key Results: Our analysis demonstrates that there were good agreements in leaf parameters between referenced and estimated values. A high level of overlap was also found between surfaces of image-based reconstructions and laser scanning. Accuracy of 3D reconstruction of curly-leaf plants was relatively lower than that of flat-leaf plants. Plant height of three plants and maximum canopy width of cucumber and pepper showed an increasing trend during the 70 d after transplanting. Maximum canopy width of eggplants reached its peak at the 40th day after transplanting. The larger leaf phenotypic parameters of cucumber were mostly found at the middle-upper leaf position. Conclusions: High-accuracy 3D evaluation of reconstruction quality indicated that dynamic capture of the 3D canopy based on the MVS approach can be potentially used in 3D phenotyping for applications in breeding and field management.

A Series of Enthalpically Optimized Docetaxel Analogues Exhibiting Enhanced Antitumor Activity and Water Solubility.

A dual-purpose strategy aimed at enhancing the binding affinity for microtubules and improving the water solubility of docetaxel led to the design and synthesis of a series of C-2- and C-3'-modified analogues. Both aims were realized when the C-3' phenyl group present in docetaxel was replaced with a propargyl alcohol. The resulting compound, 3f, was able to overcome drug resistance in cultured P-gp-overexpressing tumor cells and showed greater activity than docetaxel against drug-resistant A2780/AD ovarian cancer xenografts in mice. In addition, the considerably lower hydrophobicity of 3f relative to both docetaxel and paclitaxel led to better aqueous solubility. A molecular model of tubulin-bound 3f revealed novel hydrogen-bonding interactions between the propargyl alcohol and the polar environment provided by the side chains of Ser236, Glu27, and Arg320.

[Study of Imitation Hardened Plaque RF Ablation with Different Frequencies].

In order to solve the heat transfer mechanism in radiofrequency treatment of atherosclerosis, we design two experimental structures to simulate the plaque, and use three frequencies and a variety of electrode arrangement, to study the heat transfer mechanism and heating capacity under the special structure. The results show that the temperature increment and heating area increase with increasing frequency. Under the structure in which the lipid particles are embedded in the fiber cap, using three electrodes with opposite polar arrangement between middle electrode and others, achieves effective heating to lipid pool in the plaque.

Winter wheat ear counting based on improved YOLOv7x and Kalman filter tracking algorithm with video streaming.

Accurate and real-time field wheat ear counting is of great significance for wheat yield prediction, genetic breeding and optimized planting management. In order to realize wheat ear detection and counting under the large-resolution Unmanned Aerial Vehicle (UAV) video, Space to depth (SPD) module was added to the deep learning model YOLOv7x. The Normalized Gaussian Wasserstein Distance (NWD) Loss function is designed to create a new detection model YOLOv7xSPD. The precision, recall, F1 score and AP of the model on the test set are 95.85%, 94.71%, 95.28%, and 94.99%, respectively. The AP value is 1.67% higher than that of YOLOv7x, and 10.41%, 39.32%, 2.96%, and 0.22% higher than that of Faster RCNN, SSD, YOLOv5s, and YOLOv7. YOLOv7xSPD is combined with the Kalman filter tracking and the Hungarian matching algorithm to establish a wheat ear counting model with the video flow, called YOLOv7xSPD Counter, which can realize real-time counting of wheat ears in the field. In the video with a resolution of 3840×2160, the detection frame rate of YOLOv7xSPD Counter is about 5.5FPS. The counting results are highly correlated with the ground truth number (R2 = 0.99), and can provide model basis for wheat yield prediction, genetic breeding and optimized planting management.

Experience sharing on perioperative clinical management of gastric cancer patients based on the "China Robotic Gastric Cancer Surgery Guidelines".

BACKGROUND: With the popularization of robotic surgical systems in the field of surgery, robotic gastric cancer surgery has also been fully applied and promoted in China. The Chinese Guidelines for Robotic Gastric Cancer Surgery was published in the Chinese Journal of General Surgery in August 2021. METHODS: We have made a detailed interpretation of the process of robotic gastric cancer surgery regarding the indications, contraindications, perioperative preparation, surgical steps, complication, and postoperative management based on the recommendations of China's Guidelines for Robotic Gastric Cancer Surgery and supplemented by other surgical guidelines, consensus, and single-center experience. RESULTS: Twenty experiences of perioperative clinical management of robotic gastric cancer surgery were described in detail. CONCLUSION: We hope to bring some clinical reference values to the front-line clinicians in treating robotic gastric cancer surgery. TRIAL REGISTRATION: The guidelines were registered on the International Practice Guideline Registration Platform ( http://www.guidelines-registry.cn ) (registration number: IPGRP-2020CN199).

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) and nutrients from two constructed wetlands in a city of southeastern China.

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a large class of toxic contaminants. Nutrients are closely related to the ecological health of aquatic systems. Both have received widespread global attention. This study investigated the concentrations, compositions, and spatial distributions of PFAS and nutrients in surface water from two constructed wetlands and the nearby drinking water treatment plants (DWTPs). We explored the natural environmental factors and human activities that affect the composition and distribution of pollutants in wetlands and assessed the ability of the DWTPs to remove contaminants. Concentrations of ∑32PFAS varied from 153 to 405 ng/L. Hexafluoropropylene oxide trimer acid (HFPO-TA) was the predominant substance accounting for 45 % of ∑32PFAS concentrations. It might originate from the emissions of indirect sources of PFAS related manufacturers. The detection rate of 6:2 fluorotelomer carboxylic acid (6:2 FTCA) was 100 % with concentrations ranging from 0.915 to 19.7 ng/L 6:2 FTCA might come from the biotransformation of indirect sources in the air. Concentrations of total nitrogen (TN) and total phosphorus (TP) were from 1.47 to 3.54 mg/L, and non-detect (ND) to 0.323 mg/L, respectively. Constructed wetlands could effectively remove PFAS under nutrient stress, however, the removal of PFAS depends on the characteristics of specific compounds and their sources. The removal rates for PFAS and nutrients could be promoted through artificial dredging. But wetland bioremediation could have two opposing effects. On the one hand, plants can take up pollutants from water via roots, leading to pollutant removal and purification. On the other hand, plants may also absorb precursor intermediates from the air through leaves and release them into the water, leading to increased pollutant concentrations. Thirty-two emerging PFAS were identified by high resolution mass spectrum. The drinking water treatment process removed PFAS and nutrients below the drinking water quality standards of China, however, 9 non-target PFAS compounds were still found in tap water. These results provide case support and a theoretical basis for the pollution control and sustainable development of typical ecological wetlands used as drinking water sources.

Short-term and long-term outcomes after robotic versus open hepatectomy in patients with large hepatocellular carcinoma: a multicenter study.

BACKGROUND: Robotic hepatectomy (RH) is currently widely accepted and it is associated with some benefits when compared to open hepatectomy (OH). However, whether such benefits can still be achieved for patients with large hepatocellular carcinoma (HCC) remain unclear. This study aimed to evaluate the short-term and long-term outcomes of patients undergoing RH or OH. METHODS: Perioperative and survival data from patients with large HCC who underwent RH or OH between January 2010 and December 2020 were collected from eight centres. Propensity score matching (PSM) was performed to minimise potential biases. RESULTS: Using predefined inclusion criteria, 797 patients who underwent OH and 309 patients who underwent RH were enroled in this study. After PSM, 280 patients in the robotic group had shorter operative time (median 181 vs. 201 min, P <0.001), lower estimated blood loss (median 200 vs. 400 ml, P <0.001), and shorter postoperative length of stay (median 6 vs. 9 days, P <0.001) than 465 patients in the open group. There were no significant differences between the two groups in overall survival and recurrence-free survival. Cox analysis showed AFP greater than 400 ng/ml, tumour size greater than 10 cm, and microvascular invasion were independent risk factors for overall survival and recurrence-free survival. After PSM, subgroup analysis showed that patients with a huge HCC (diameter >10 cm) who underwent RH had significantly lower estimated blood loss (median 200.0 vs. 500.0 min, P <0.001), and shorter length of stay (median 7 vs. 10 days, P <0.001) than those who underwent OH. CONCLUSION: Safety and feasibility of RH and OH for patients with large HCC were comparable. RH resulted in similar long-term survival outcomes as OH.