bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stapling of an endobronchial suction tube with the bronchus during robot-assisted right lower lobectomy: a case report
Authors: Tanaka Hiroto , Aoki Teruhiro , Oda Makoto , Inoue Yoshimasa 
Published: August 2021

Abstract
Background
Troubleshooting intraoperative complications requires careful management, and the safest technique should be chosen. We recently experienced a unique intraoperative bronchial complication during pulmonary lobectomy in robot-assisted thoracic surgery (RATS). There is no consensus on whether to continue RATS or convert to a more familiar technique, such as video-assisted thoracic surgery (VATS) or thoracotomy, for intraoperative complications that occur during RATS, and the decision should be determined individually.

Case presentation
A 74-year-old woman with primary lung adenocarcinoma (clinical stage IA2) underwent robot-assisted right lower lobectomy under one-lung ventilation and CO2 insufflation. Intraoperatively, the anesthesiologist placed the endobronchial suction tube in the right bronchus with intention of maintaining the right lung collapse, which was simultaneously stapled with the right lower bronchus during the right lower lobe bronchial closure using a robotic stapler. During robot-assisted manipulation, we removed the staples involved with the suction tube, one by one, using robotic-arm forceps and sutured the partially opened stump. Subsequently, the bronchial stump was covered with a pedicled pericardial fat pad. The postoperative course was uneventful, and the patient developed no complications when followed up 8 months after discharge. Hence, we could rectify this intraoperative bronchial complication using a robot-assisted technique and avoid conversion to VATS or thoracotomy.

Conclusion
The precise manipulation techniques in RATS contributed to facilitate the successful execution of surgical procedures, such as staple removal and re-suturing of the bronchial stump and may be a useful as a method for such troubleshooting such intraoperative complications.
Developing Healthcare Team Observations for Patient Safety (HTOPS): senior medical students capture everyday clinical moments
Authors: Anderson E. S. , Griffiths T. R. L. , Forey T. , Wobi F. , Norman R. I. , Martin G. 
Published: August 2021

Abstract
Background
Aviation has used a real-time observation method to advance anonymised feedback to the front-line and improve safe practice. Using an experiential learning method, this pilot study aimed to develop an observation-based real-time learning tool for final-year medical students with potential wider use in clinical practice.

Methods
Using participatory action research, we collected data on medical students’ observations of real-time clinical practice. The observation data was analysed thematically and shared with a steering group of experts to agree a framework for recording observations. A sample of students (observers) and front-line clinical staff (observed) completed one-to-one interviews on their experiences. The interviews were analysed using thematic analysis.

Results
Thirty-seven medical students identified 917 issues in wards, theatres and clinics in an acute hospital trust. These issues were grouped into the themes of human influences, work environment and systems. Aviation approaches were adapted to develop an app capable of recording real-time positive and negative clinical incidents. Five students and eleven clinical staff were interviewed and shared their views on the value of a process that helped them learn and has the potential to advance the quality of practice. Concerns were shared about how the observational process is managed.

Conclusion
The study developed an app (Healthcare Team Observations for Patient Safety—HTOPS), for recording good and poor clinical individual and team behaviour in acute-care practice. The process advanced medical student learning about patient safety. The tool can identify the totality of patient safety practice and illuminate strength and weakness. HTOPS offers the opportunity for collective ownership of safety concerns without blame and has been positively received by all stakeholders. The next steps will further refine the app for use in all clinical areas for capturing light noise.
Rationale and proposed framework for shared decision making in cardio-oncology
Authors: Hull Sarah C. , Soufer Aaron , Spatz Erica S. , Baldassarre Lauren A. 
Published: August 2021

AbstractPhysicians have a duty to present diagnostic and therapeutic choices with rational guidance that respects patient values and realizes patient goals. In cardio-oncology, we commonly encounter patients who understandably feel overwhelmed or feel that they have no favorable options, particularly in the context of advanced malignancy. Accordingly, a longitudinal multidisciplinary commitment to shared decision making (SDM) ensures that physicians and patients actively participate in this process to promote the best possible outcomes from the patient perspective. We propose a practical framework for approaching these difficult decisions in cardio-oncology drawing upon our experience in clinical practice.
Risk factors for periprocedural ischemic stroke following endovascular treatment of intracranial aneurysms
Authors: Zhang Yisen , Wang Chao , Tian Zhongbin , Zhu Wei , Li Wenqiang , Yang Xinjian , Liu Jian , Zhang Ying 
Published: August 2021

Abstract
Background
The aim of this study was to comprehensively evaluate the risk factors of periprocedural ischemic stroke associated with endovascular treatment of intracranial aneurysms using a real-world database.

Methods
From August 2016 to March 2017, 167 patients were enrolled. Univariate analysis and multivariate logistic regression analysis were used to examine the risk factors for periprocedural ischemic stroke.

Results
Among the 167 cases, periprocedural ischemic stroke occurred in 20 cases (11.98%). After univariate analysis, the ischemic group had a higher proportion of large (≥ 10 mm) aneurysms than the control group (45.0% vs. 23.1%, p = 0.036). The incidence of periprocedural ischemic stroke was higher in cases treated by flow diverter (21.6%) or stent-assisted coiling (11.8%) than in cases treated by coiling only (2.7%), and the differences were statistically significant (p = 0.043). After multivariate logistic regression analysis, treatment modality was the independent risk factor for periprocedural ischemic stroke. Compared with the coiling-only procedure, flow diverter therapy was associated with a significantly higher rate of periprocedural ischemic stroke (OR 9.931; 95% CI 1.174–84.038; p = 0.035).

Conclusions
Aneurysm size and treatment modality were associated with periprocedural ischemic stroke. Larger aneurysms were associated with increased risk of periprocedural ischemic stroke. Flow diverter therapy was associated with significantly more periprocedural ischemic stroke than the coiling procedure alone.
Geographical range expansion of Nitzschia volvendirostrata Ashworth, Dąbek & Witkowski, 2016 (Bacillariophyta: Bacillariaceae) based on morphological and molecular analysis
Authors: Lora-Vilchis María Concepción , Murugan Gopal , López-Fuerte Francisco Omar 
Published: August 2021

AbstractIn diatoms the use of molecular tools to corroborate traditional (morphological) identification offers a new perspective in the field of biogeography. This manuscript reports the first record of the raphid pennate diatom Nitzschia volvendirostrata along the coast of Mexico, which in turn represents an expansion of the geographic range along the American continent. The cells were isolated from benthic samples taken from Balandra lagoon, La Paz, Baja California Sur, Mexico and cultured as a monoclonal culture. Morphology and morphometry of the diatom obtained from light and electron microscopy reveal that they correspond to the original description of N. volvendirostrata and also its chloroplast sequences, rbcL and psbC, showed 98.7 to 100 % similarity and a close phylogenetic relationship with N. volvendirostrata. The reported places for this taxon show that it has a tropical-temperate biogeographical affinity.
Predictive model and feature importance for early detection of type II diabetes mellitus
Authors: Adua Eric , Kolog Emmanuel Awuni , Afrifa-Yamoah Ebenezer , Amankwah Bright , Obirikorang Christian , Anto Enoch Odame , Acheampong Emmanuel , Wang Wei , Tetteh Antonia Yarney 
Published: August 2021

AbstractBackgroundAccurate prediction and early recognition of type II diabetes (T2DM) will lead to timely and meaningful interventions, while preventing T2DM associated complications. In this context, machine learning (ML) is promising, as it can transform vast amount of T2DM data into clinically relevant information. This study compares multiple ML techniques for predictive modelling based on different T2DM associated variables in an African population, Ghana.MethodsThe study involved 219 T2DM patients and 219 healthy individuals who were recruited from the hospital and the local community, respectively. Anthropometric and biochemical information including glycated haemoglobin (HbA1c), body mass index (BMI), blood pressure, fasting blood sugar (FBS), serum lipids [(total cholesterol (TC), triglycerides (TG), high and low-density lipoprotein cholesterol (HDL-c and LDL-c)] were collected. From this data, four ML classification algorithms including Naïve-Bayes (NB), K-Nearest Neighbor (KNN), Support Vector Machines (SVM) and Decision Tree (DT) were used to predict T2DM. Precision, Recall, F1-Scores, Receiver Operating Characteristics (ROC) scores and the confusion matrix were computed to determine the performance of the various algorithms while the importance of the feature attributes was determined by recursive feature elimination technique.ResultsAll the classifiers performed beyond the acceptable threshold of 70% for Precision, Recall, F-score and Accuracy. After building the predictive model, 82% of diabetic test data was detected by the NB classifier, of which 93% were accurately predicted. The SVM classifier was the second-best performing classifier which yielded an overall accuracy of 84%. The non-T2DM test data yielded an accurate prediction score of 75% from the 98% of the proportion of the non-T2DM test data. KNN and DT yielded accuracies of 83% and 81%, respectively. NB had the best performance (AUC = 0.87) followed by SVM (AUC = 0.84), KNN (AUC = 0.85) and DT (AUC = 0.81). The best three feature attributes, in order of importance, were HbA1c, TC and BMI whereas the least three importance of the features were Age, HDL-c and LDL-c.ConclusionBased on the predictive performance and high accuracy, the study has shown the potential of ML as a robust forecasting tool for T2DM. Our results can be a benchmark for guiding policy decisions in T2DM surveillance in resource and medical expertise limited countries such as Ghana.
Hybrid intelligence approach for multi-load level reactive power planning using VAR compensator in power transmission network
Authors: Karmakar Nihar , Bhattacharyya Biplab 
Published: August 2021

AbstractThis paper formulates and solves a techno-economic planning problem of reactive power (VAR) in power transmission systems under loadings. The objective of the proposed research work is to minimize the combination of installation cost of reactive power sources, power losses and operational cost while satisfying technical constraints. Initially, the positions for the placement of reactive power sources are determined technically. Different cost components such as VAR generation cost, line charging cost etc. are then added in the total operating cost in a most economical way. Finally, the optimal parameter setting subjected to reactive power planning (RPP) is obtained by taking advantages of hybrid soft computing techniques. For the justification of the efficiency and efficacy of the proposed approach the entire work is simulated on two inter-regional transmission networks. To validate the robustness and ease of the soft computing techniques in RPP the responses of benchmark functions and statistical proof are provided simultaneously.
Superimposed polygonal approximation analysis comparing 2D photography and 3D scanned images of bite marks on human skin
Authors: Rizwal Ain Ashraf , Azahar Nursyereen , Reduwan Nor Hidayah , Yusof Mohd Yusmiaidil Putera Mohd 
Published: August 2021

Abstract
Background
Preservation of bite marks evidence has always been a major problem in forensic odontology due to progressive loss of details as time passes. The use of 2D photographs has been widely used to document forensic evidence and preserving bite marks; however, there are limitations to this method. This study aims to measure the accuracy of the 3D scanned image in comparison to 2D photograph registration of experimental bite marks. Thirty volunteers performed self-exertions of a bite mark on the respective forearm of subjects. A 2D photograph and 3D scanned image was immediately registered following bite mark exercise using a conventional camera and Afinia EinScan-Pro 2X PLUS Handheld 3D Scanner, respectively. The outlines of the bite mark were transformed into a polygonal shape. Next, the polygonal approximation analysis was performed by an arbitrary superimposition method. The difference between surface areas of both images was calculated (2D photographs ̶ 3D scanned images).

Results
A paired t test was used to measure significance with α = 0.05. The mean surface area of 2D photographs and 3D scanned images is 31.535 cm2 and 31.822 cm2, respectively. No statistical difference was found between both mean surface areas (p > 0.05). The mean error (ME) is 0.287 ± 3.424 cm2 and the mean absolute error (MAE) is 1.733 ± 1.149 cm2.

Conclusion
Bite marks registered with the 3D scanned image are comparable to the standard 2D photograph for bite mark evaluations. The use of a 3D scan may be adopted as a standard operating procedure in the forensic application, especially for evidence preservation.
Effect of Bacillus safensis NBRC 100820 isolated from cotton plant against the spiny bollworm, Earias insulana (Boisduval)
Authors: El-Sayed Ali Ahmed , Ghaly Mohammed Farouk , Amer Ahmed Adel 
Published: August 2021

AbstractBackgroundToxic effect of some local bacterial isolates, isolated from the Egyptian cotton plant (Gossypium barbadanceL.), on larvae of the spiny bollworm (SBW),Earias insulana(Boisduval) (Lepidoptera: Nolidae) was studied as well as the biological effects of the most toxic isolate.ResultsBacillus safensisNBRC 100820 had the most toxic effect on the SBW larvae compared to other isolates. Larval mortality percentages were 100, 90, 50, 50 and 30% for newly hatched, 3, 5, 7 and 10-day’s old larvae, respectively, after 2 days from treatment. Moreover,B. safensisNBRC 100820 caused latent effects on different stages of SBW. It decreased the larval and pupal weight, percentages of adult emergence and hatchability as well as number of deposited eggs/female more than the control. Using 16s rRNA confirmed the identification ofB. safensisNBRC 100820 and its accession number is MW281809.ConclusionsUse ofB. safensisNBRC 100820 can be recommended for biological control ofE. insulana. Further field studies are needed.
Applicability of carbothermic reduction for upgrading Sri Lankan ilmenite ores: towards converting ilmenite into synthetic rutile by mechanical activation
Authors: Wijewardhana T. Dilmi. U. , Ratnayake Amila Sandaruwan 
Published: August 2021

Abstract
Background
Ilmenite and rutile are naturally occurring titanium-bearing heavy minerals. Sri Lanka consists of ilmenite and rutile in placer deposits mainly along the northeast coast. The commercial value of rutile is higher than ilmenite. Therefore, the current study focuses to upgrade Sri Lankan ilmenite ores using commercially available activated carbon as a reducing agent. Ilmenite fraction was initially separated from raw beach sand using an industrial-scale magnetic separator (Wet high-intensity magnetic separator: sixteen pole model). The mixtures of ilmenite and activated carbon (4 to 1 ratio by weight) were milled using a planetary ball mill for one to four hours at one-hour intervals.

Results
The milled samples were subsequently heated for two hours continuously at temperatures of 800 °C, 900 °C, 1000 °C, 1100 °C, and 1200 °C, respectively. Initial and annealed samples were analysed using X-ray diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, and X-ray fluorescence (XRF) analyses. XRD pattern of the initial sample was characterized by less percentage of rutile (TiO2) peaks and low crystallinity. However, the number of rutile peaks and crystallinity were increased with respective milling hours and annealed temperature. Besides, XRD analysis indicates a higher number of sharp and intense rutile and elemental iron peaks in the samples annealed above 1000 °C. FTIR analysis of raw ilmenite indicates mainly stretching vibrations of Fe–O. However, vibrational spectral bands around 700 cm−1 in samples annealed above 1000 °C are assigned to Ti–O–Ti stretching vibrations. High TiO2 and TiO2 + Fe2O3 (total) wt. (%) can also be observed in samples annealed above 1000 °C.

Conclusions
The optimum conditions for carbothermic reduction were obtained at 4 h of ball milling of ilmenite with activated carbon and continuously annealing at 1000 °C for 2 h. Carbothermic reduction is applicable to upgrade Sri Lankan ilmenite ores, and thus this method adds value to heavy mineral resources in Sri Lanka.
Teachers’ use of ICT in implementing the competency-based curriculum in Kenyan public primary schools
Authors: Murithi Julius , Yoo Jin Eun 
Published: August 2021

AbstractThe use of Information and Communication Technology (ICT) in education has been widely advocated as much needed 21st-century skills by governments and policymakers. Nevertheless, several challenges in integrating ICT into the curriculum have been reported in previous research, especially in studies on Sub-Saharan African countries. Focusing on the case of Kenyan public primary schools, this study investigated the availability of ICT facilities; teacher capacity to integrate technology into their lessons; and teacher perceptions towards technology in schools. In particular, the study is premised on the constructivist learning theory and the Technology Acceptance Model. A total of 351 teachers completed an online questionnaire. Teachers perceived that ICT facilities were inadequate in schools, which presented a challenge in the integration of technology during the implementation of the new curriculum. Most of the teachers answered that they received only basic computer literacy training. Although teachers perceived the use of computers as necessary, they faced difficulties integrating technology in their lessons. The effect of age and gender on teacher capacity was also investigated in inferential statistics, specifically with Welch tests and Games-Howell post hoc comparisons. Teachers in their 40s had a higher perception of usefulness than teachers in the 30s. Implications of the study are discussed as well as future research topics.
Amelioration of polycystic ovary syndrome-related disorders by supplementation of thymoquinone and metformin
Authors: Ammar Islam Mohamed Magdi , Salem Mostafa Abdo Ahmed 
Published: August 2021

Abstract
Background
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders of reproductive age women with a prevalence of 4-12%. The study aimed to investigate the potential benefit of adding thymoquinone to metformin in alleviating symptoms of polycystic ovarian syndrome. Two hundred seven overweight and obese PCOS patients were divided into two groups. Patients in group A received metformin 500 mg three times daily for 6 months. Patients in group B received a combination of metformin 500 mg and thymoquinone in the form of black cumin oil 500 mg capsules three times daily for 6 months. Follow-up was done after 3 and 6 months from the beginning of the study for evaluation of menstrual cycle pattern, body mass index, waist circumference, hip circumference, and waist:hip ratio, oral glucose tolerance test, glycosylated hemoglobin A1C, superoxide dismutase activity, and malondialdehyde concentration.

Results
Patients who received a combination of black cumin oil capsules and metformin, showed a significant decrease in number of patients suffering from amenorrhea or oligomenorrhea (P = 0.031), significant (P = 0.00) weight reduction (reduced BMI), and body fat redistribution (reduced W/H ratio), regaining oxidative balance with significant increase of SOD activity (P = 0.00) and decrease of MDA concentrations (P = 0.03). Regarding the number of prediabetic patients, there was no statistically significant difference (P = 0.89) when both groups were compared at the end of study period.

Conclusions
Black cumin oil supplementation constitutes a beneficial added value to metformin in ameliorating PCOS-related disorders with resumption of menstrual regularity, weight reduction, change of body fat distribution, and regaining oxidative balance.
Role of multidetector CT in predicting patient outcome in cases of pulmonary embolism: correlation between imaging findings, ICU admissions and mortality rate
Authors: Ibrahim Heba , El-Maadawy Samar M. 
Published: August 2021

Abstract
Background
Pulmonary embolism (PE) is a critical medical condition that requires prompt diagnosis and treatment to avoid serious morbidity and mortality risk. Multidetector CT pulmonary angiography (CTPA) is considered the first-line imaging modality for suspected acute PE. The presence of right heart strain, which supports the diagnosis, requires special attention. The aim of our retrospective study is to assess the reliability of CTPA hemodynamic indices in predicting patients’ outcome in cases of PE.

Results
Sixty patients were included in our study. CTPA parameters including main pulmonary artery (MPA) diameter, left ventricle (LV) diameter, right ventricle (RV)/LV ratio, and septal deviation had a clinical prognostic value for short-term 30-day mortality and ICU admission. Statistically significant relationship between MPA diameter > 29 mm, LV diameter, RV/LV ratio > 1, left-sided septal deviation and contrast reflux into the IVC/distal hepatic veins with ICU admission was observed with p values 0.031, 0.000, 0.000, 0.005 and 0.028 respectively. There was a statistically significant correlation between MPA diameter > 29 mm, LV diameter, RV/LV > 1 ratio and septal deviation with 30-day mortality with p values of < 0.001, 0.001, < 0.001 and 0.015 respectively. No significant correlation was found between 30-day mortality and contrast reflux to IVC with p value of 0.070.

Conclusions
CTPA measurements including MPA diameter, RV/LV ratio and septal deviation were found to be significantly correlated to ICU admission and 30-day mortality as predictors for PE severity. CT contrast reflux was found to be correlated to ICU admission; however, it was not significantly correlated to 30-day mortality.