bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technical Considerations for Reducing The Cost of Robotic Lobectomy for Lung Cancer
Authors: Hashimoto Kohei , Sakamaki Hiroyuki , Kumeda Hirotaka , Agatsuma Hiroyuki , Yoshida Kazuo 
Published: June 2021

Abstract
Background

The cost of robotic assisted surgery is an obstacle to wider implementation. We aimed to evaluate the effect of our strategy to reduce the cost of robotic lobectomy (RL) for lung cancer.
Methods

This single institutional retrospective study included RL for lung cancer between October 2018 to November 2019. We initiated minimal RL (miRL) in September 2019 aiming to reduce the consumable cost, in which we intended to use only bipolar fenestrated (left), long bipolar grasper (right) and vessel sealer (3rd arm) as robotic instrument. Additional consumable cost was calculated based on Japanese catalog price (1USD = 110JPY) to perform RL (excluding robot and maintenance fee, and staplers) compared to our video assisted thoracoscopic surgery lobectomy (VATS-L) (3 ports, no energy device). We then assessed the effect of miRL on the cost and perioperative outcomes.
Results

Twenty-one RATS-L were performed [20 c-stage I and one c-T3(PM1)N0M0]. There were no significant differences in patient characteristics between the miRL group (N = 6) [age 73(56–76); male 67%; tumor size 18(5–33) mm] and the Control group (N = 15) [age 68(50–84); male 60%; tumor size 13(8–32) mm]. In all cases with miRL, procedure was completed with only 3 arms. The mean (range) additional consumable cost to perform RL compared to VATS-L was significantly reduced in the miRL group compared to the control group [Control 2168(1808–2746) vs miRL 1424(1424–1424) USD, p༜0.01]. There was no conversion to thoracotomy or grade > 4 complications. There were no significant differences in blood loss [Control 25(0-203) vs miRL 30(0-152) g, p = 0.90], operation duration [Control 193(106–284) vs miRL 179(154–211) mins, p = 0.53] or postoperative hospital stay [Control 4(3–10) vs miRL 4(3–17) days, p = 0.87].
Conclusions

With miRL strategy in our cohort, consumable cost for RATS-L was significantly reduced while maintaining perioperative outcomes. Further evaluation with larger number of patients is warranted.
Pharmacoeconomic Analysis of Biologics and Methotrexate for Rheumatoid Arthritis from the Standpoint of the Number Needed to Treat Concept under the Japanese Health Insurance System
Authors: Harigane Kengo , Mochida Yuichi , Shimazaki Takayuki , Kobayashi Naomi , Inaba Yutaka 
Published: June 2021

Abstract
Objectives: To evaluate the cost-effectiveness of biologics and methotrexate (MTX) for rheumatoid arthritis (RA) using the number needed to treat (NNT) concept and total actual health care cost.Methods: This study included 121 RA patients with newly prescribed biologics and/or MTX between 2012 and 2017. The NNT was calculated based on the 24-week remission rate of Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-ESR) and Clinical Disease Activity Index (CDAI).Results: Remission rates were 76.4% for DAS28-ESR and 45.4% for CDAI in the biologics group and 63.6% and 24.2%, respectively, in the MTX group. The NNT was calculated as 6.4 and 4.2 in the biologics group and 34.2 and 35.2 in the MTX group, respectively. Mean total actual health care costs were 1,044,066 JPY (9,835 US$)/24 weeks per treated patient in the biologics group and 75,860 JPY (715 US$)/24 weeks in the MTX group. Although the effectiveness of biologics was superior to MTX from the standpoint of NNT, the mean total health care cost and mean cost per NNT were much higher in the biologics group.Conclusions: Cost-effectiveness is clearly higher for MTX than biologics from the standpoint of NNT and total actual health care cost under the Japanese health insurance system.
Diversification Through Gustatorial-Courtship: An X-ray Micro-Computed Tomography Study on Dwarf Spiders
Authors: Lin Shou-Wang , Lopardo Lara , Uhl Gabriele 
Published: June 2021

Abstract
BackgroundSexual selection has been considered to promote diversification and speciation. Sexually dimorphic species have been used to explore the supposed effect, however, with mixed results. In dwarf spiders (Erigoninae), many species are sexually dimorphic - males possess marked prosomal modifications. These male traits vary from moderate elevation to bizarre shapes in various prosomal regions. Previous studies established that male dwarf spiders produce substances in these prosomal modifications that are taken up by the female. Since the transfer of substances increases mating probability of males and oviposition rate in females, the dimorphic traits evolved in the context of sexual selection. Here, we explore the evolutionary lability of the gustatory trait complex by investigating 1) if erigonine modified prosomata are inherently linked to nuptial-gift-producing glands, 2) if gland evolution preceded that of the modified prosomal shapes and by assessing 3) the probability of convergent evolution and cryptic differentiation - with the aim of assessing the role of this trait complex in species divergence.ResultsWe reconstructed the position and extent of the glandular tissue along with the muscular anatomy in the anterior part of the prosoma of 76 erigonine spiders and three outgroup species using X-ray micro-computed tomography. We incorporated the location of glands and muscles into an existing matrix of somatic and genitalic morphological traits of these taxa and reanalyzed their phylogenetic relationship. Our analysis supports that possession of glandular equipment is the ancestral state. The manifold modifications of the prosomal shape have evolved convergently multiple times. We found differences in glandular position between species with both modified and unmodified prosomata, and reported on seven cases of gland loss. ConclusionsOur findings suggest that the occurrence of gustatory gland in sexually monomorphic ancestors has set the stage for the evolution of diverse dimorphic external modifications in dwarf spiders. Variation among congeners indicates that glandular position is highly susceptible to changes. Multiple incidences of gland loss suggest considerable maintenance costs of glandular tissue and nuptial feeding. Our results demonstrate divergent evolutionary patterns of gustatorial-courtship-related traits, and a likely facilitating effect of this type of sexual selection on speciation
COVID-19 Biomedical Waste Management: Knowledge Assessment Among Medical Professionals in a COVID-19 Dedicated Hospital, a Cross Sectional Study.
Authors: Afsar Aiman Perween , Bains Lovenish , Mishra Anurag , Dabaas Aashima , Mittal Akshit , Aggarwal Sulakshna , Kaur Daljit 
Published: June 2021

Abstract
Background Nations have faced significant challenges with the COVID-19 related biomedical waste since its outbreak. Before the pandemic, Indian hospitals typically generated 500g of BMW per bed each day, which has now risen to about 2.5-4 kg per bed per day. Proper BMW aims to reduce waste generation, ensures efficient collection, handling and safe disposal that it controls infection and improves safety for the medical professionals. Hence, the present study was conducted to assess the level of knowledge among medical professionals regarding biomedical waste segregation , transport and treatment and thereafter provide constructive suggestions to reduce mismanagement practices. Methodology An e-survey was done to assess the knowledge and awareness of management of Biomedical Waste generated due to Covid-19 among Medical Professionals (students, residents and consultants) of tertiary care hospital of North India. Result The average knowledge score about BMW waste generated due to Covid-19 was found to be: for segregation - 27.46%, 59.615%, and 49.8%; transport of waste from site of generation to the site of disposal- 63.66%, 89.1% and 95.2% ; disposal of waste generated- 29%, 71.96%, and 68.24% in students, residents, and consultants respectively. Overall, the knowledge score was 41.4%, 67.98%, and 61.34% among the students, residents and consultants respectively. We found that participants with greater years of experience (residents and consultants) had better knowledge compared to that of the students(p<0.05). Discussion Our study found that the mean score was 56.9% which is comparably more than the knowledge score of few Low and Middle Income Countries but less than the knowledge score of some European countries. Studies have found that the chances of infection directly correlates with the low level of knowledge. This underlines that training aspects of health-care waste management should be strengthened, not only for the practising medical professionals but also of the students so that the current, existing, and future regulations are practiced diligently and uniformly. Hence, it is important that we strengthen the training aspect of medical professionals. Periodic evaluation and assessment should become routine to enforce adherence to waste management.
Appearance of Claudin-5+ Leukocyte Subtypes in the Blood and CNS During Progression of EAE
Authors: Krajewski Dylan , Paul Debayon , Ge Shujun , Jellison Evan , Pachter Joel S. 
Published: June 2021

Abstract
Background: Tight junctions (TJs) are membrane specializations characteristic of barrier-forming membranes, which function to seal the aqueous pathway between endothelial cells or epithelial cells and, thereby, obstruct intercellular solute and cellular movement. However, previous work from our laboratory found that claudin-5 (CLN-5), a TJ protein prominent at the blood-brain barrier (BBB), is also detected, ectopically, on leukocytes (CLN-5+) in the blood and central nervous system (CNS) of mice with experimental autoimmune encephalomyelitis (EAE), a neuroinflammatory, demyelinating disease that is a model for multiple sclerosis. CLN-5 was further shown to be transferred from endothelial cells to circulating leukocytes during disease, prompting consideration this action is coupled to leukocyte transendothelial migration (TEM) into the CNS by fostering transient interactions between corresponding leukocyte and endothelial junctional proteins at the BBB. Methods: To begin clarifying the significance of CLN-5+ leukocytes, flow cytometry was used to determine their appearance in the blood and CNS during EAE. Results: Flow cytometric analysis revealed CLN-5+ populations among CD4 and CD8 T cells, B cells, monocytes and neutrophils, and these appeared with varying kinetics and to different extents in both blood and CNS. CLN-5 levels on circulating T cells further correlated highly with activation state. And, percentage of CLN-5+ cells among each of the subtypes analyzed was considerably higher in CNS tissue than in blood, consistent with the interpretation that CLN-5+ leukocytes gain preferred access to the CNS. Conclusion: Several leukocyte subtypes variably acquire CLN-5 in blood before they enter the CNS, an event that may represent a novel mechanism to guide leukocytes to sites for paracellular diapedesis across the BBB.
Nitrate modulation of Bacillus sp. biofilm components: a proposed model for sustainable bioremediation
Authors: Gomaa Ola , Kareem Hussein Abd E EL , Selim Nabila 
Published: June 2021

Abstract
The presence of different pollutants in wastewater hinder microbial growth, compromise enzymatic activity or compete for electrons required for bioremediation pathway. Therefore, there is a need to use a single microorganism that is capable of tolerating different toxic compounds and can perform simultaneous bioremediation. In the present study, nitrate reducing bacteria capable of decolorizing azo dye was identified as Bacillus subtillis sp. DN using Protein profiling, morphological and biochemical tests X-ray diffraction pattern, Raman spectroscopy and cyclic voltammetry confirm that the bacterium under study possesses membrane-bound nitrate reductase and that is capable of direct electron transfer. The addition of nitrate concentrations (0–50 mM) resulted in increased biofilm formation with variable exopolysaccharides (EPS), protein, and eDNA. Fourier Transform Infrared spectrum revealed the presence of a biopolymer at high nitrate concentrations. Effective capacitance and conductivity of the cells grown in different nitrate concentrations suggest changes in the relative position of polar groups, their relative orientation and permeability of cell membrane as detected by dielectric spectroscopy. The increase in biofilm shifted the removal of the azo dye from biodegradation to bioadsorption. Our results indicate that nitrate modulates biofilm components. Bacillus sp. DN granular biofilm can be used for simultaneous nitrate and azo dye removal from wastewater.
Recalcitrance of Corn Straw Significantly Correlated to the Heterogeneity in Physicochemical Properties of Cell Wall
Authors: Wang Yufen , Xu Xianyang , Xue Huiting , Zhang Dejian , Li Guanhua 
Published: June 2021

Abstract
Background: Tissue heterogeneity significantly influences the overall saccharification efficiency of plant biomass. However, the mechanisms of specific organ or tissue recalcitrance to enzymatic deconstruction are generally complicated and unclear. A multidimensional analysis for the four parts from twelve corn cultivars was conducted.Results: The results showed that leaf, sheath, pith and rind of corn straw exhibited remarkable heterogeneity in chemical composition, physical structure and cell type, which resulted in the different recalcitrance to enzymatic hydrolysis. High values of lignin, hemicelluloses, degree of polymerization and crystallinity index were critical for the increased recalcitrance, while high value of neutral detergent soluble and pore size generated weak recalcitrance. Interestingly, pore traits of cell wall, especial for microcosmic interface structure, seemed to be a crucial factor that correlated to cellulase adsorption and further affected saccharification.Conclusions: Tissue heterogeneity in physical-chemical traits of cell wall influences the overall saccharification efficiency of biomass. Furthermore, the holistic outlook of cell wall interface is indispensable to understand the recalcitrance and promote the biomass conversion.
Forecasting Inflation in Latin American Countries Using a SARIMA-LSTM Combination
Authors: Peirano Rodrigo , Kristjanpoller Werner , Minutolo Marcel 
Published: June 2021

Abstract
Inflation forecasting has been and continues to be an important issue for the world's economies. Governments, through their central banks, watch closely inflation indicators to make national decisions and policies. Controlling growth and contraction requires governments to keep a close eye on the rate of inflation. When planning strategic national investments, governments attempt to forecast inflation over longer periods of time. Getting the inflation forecast wrong, can result in significant economic hardships. However, even given its significance, there is limited new research that applies updated methodologies to forecast it, and even fewer studies in emerging economies where inflation may be drastically higher. This study proposes to forecast the inflation rate in emerging economies based on the commonly used Seasonal Autoregressive Integrated Moving Average (SARIMA) approach combined with Long Short Term Memory (LSTM). The results indicate that the proposed model based on the combination of SARIMA and LSTM, have a higher accuracy in inflation forecasts as measured by the Mean Square Error (MSE) of the proposed models over the SARIMA model and LSTM alone. The loss function used is Mean Squared Error (MSE), and the Model Confidence Set (MCS) is used to test the superiority of the models in the economies of Mexico, Colombia and Peru.
Knowledge and Practice of Exclusive Breastfeeding Among Mothers of Children Under One Years in Boudha
Authors: Deula Anju 
Published: June 2021

Abstract
Breast milk is the best nutrition for babies to achieve proper, growth and development and is said to be the first immunization, but in content of Nepal only one in two child less than age of six months is exclusively breastfed. So this study helped to find the knowledge and their practice regarding exclusive breastfeeding in women living Boudha area. Methodology: This is quantitative study, done by simple random sampling method. Data collection was done by interviewing 194 mothers in community by using structure questionnaire. The data was entered in SPSS v.22, after cleaning and coding, data were analyzed using chi-square statistical test as well as basic descriptive statistics. Results: This study was conducted among mothers of children under 1 year. Total responded were 194 with mean age and standard derivation of 26, 4.01. The minimum age of 16 years and maximum age of 36 years. Majority of the respondents are literate. Most of the respondents 48.5% are house wife, 44.3% monthly earning is below Rs 25000. All the respondents 100% do breast fed their babies. Good numbers of respondents 96.4% have high knowledge on breastfeeding. There is association between knowledge and practice (P value 0.06) and association between education and knowledge (P value 0.00) as well as there is association between occupation and knowledge (P value 0.047). Moreover, the current study found that there is no association between education and practice. Conclusion: Present study shows that knowledge of exclusive breastfeeding among mothers living in Boudha are good compare to practice. There should be awareness program needed to address to improve their practice also.
Towards low-energy-light-driven bistable photoswitches: ortho-fluoroaminoazobenzenes
Authors: Kuntze Kim , Viljakka Jani , Titov Evgenii , Ahmed Zafar , Kalenius Elina , Saalfrank Peter , Priimagi Arri 
Published: June 2021

Abstract
Thermally stable photoswitches that are driven with low-energy light are rare, yet crucial for extending the applicability of photoresponsive molecules and materials towards, e.g., living systems. Combined ortho-fluorination and -amination couples high visible-light absorptivity of o-aminoazobenzenes with the extraordinary bistability of o-fluoroazobenzenes. Herein, we report a library of easily accessible o-aminofluoroazobenzenes and establish structure–property relationships regarding spectral qualities, visible light isomerization efficiency and thermal stability of the cis-isomer with respect to the degree of o-substitution and choice of amino substituent. We rationalize the experimental results with quantum chemical calculations, revealing the nature of low-lying excited states and providing insight into thermal isomerization. The synthesized azobenzenes absorb at up to 600 nm and their thermal cis-lifetimes range from milliseconds to months. The most unique example can be driven from trans to cis with any wavelength from UV up to 595 nm, while still exhibiting a thermal cis-lifetime of 81 days.
Insights on the Small Tsunami from 28 January 2020 Caribbean Sea MW7.7 Earthquake by Numerical Simulation and Spectral Analysis
Authors: Xu Zhiguo , Sun Lining , Rahman Mohd Nashriq Abd , Liang Shanshan , Shi Jianyu , Li Hongwei 
Published: June 2021

Abstract
A huge left-lateral strike-slip Mw7.7 earthquake struck the Caribbean Sea on January 28, 2020. Thus, a small tsunami was generated as as result of the earthquake. The information and observational data gathered for the earthquake and tsunami, as well as integrating the regional tectonic setting, were used to describe the seismogenic source’s properties. The COMCOT model was used for tsunami simulation, with Okada’s dislocation model from finite fault solutions for MW7.7 Caribbean Sea earthquake published by the USGS. The simulation results were compare to tide gauge records to validate whether the seafloor vertical displacements generated by strike-slip fault caused a small tsunami. We conduct spectral analysis of tsunami to better understand the characteristics of tsunami records. Tsunami simulation results show that the coseismic vertical displacement caused by a strike-slip MW7.7 earthquake can contribute to the small tsunami, and the anomalously large high-frequency tsunami waves recorded by the George tide gauge in 11 minutes after the earthquake were unrelated to the earthquake-generated tsunami. According to spectrum analysis. The predominant period of the noticeable high frequency tsunami wave recorded by George tide gauge is only 2 minutes. This indicates that the source of small tsunami was close to the George station and travelled a distance of ~ 150 km, indicating a submarine landslide caused by the strike-slip earthquake. The comprehensive analysis shows that the small-scale tsunami was not caused solely by coseismic seafloor deformation from this strike-slip event, but that earthquake-triggered submarine landslide was the primary cause. Hence, the combined effect of two sources leads to the small-scale tsunami.
Treatment of Hand and Wrist Fractures with the Stryker Hand Plating System
Authors: Biehl Christoph , Stötzel Sabine , Schock Lydia , Szalay Gabor , Heiss Christian 
Published: June 2021

Abstract
Background: 10% of all fractures occur in the fingers and metacarpal region. Early mobilization with preservation of grip function is the goal of any therapy for these injuries. Osteosyntheses with plates are used in complex fractures that do not allow any other treatment. The aim of this retrospective study was to evaluate the performance and safety of the Stryker Hand System.Patients and Methods: Between 2010 and 2019, 190 patients underwent surgical treatment with plates for fractures of the fingers and metacarpal region. Of these, 140 operations could be analyzed according to the inclusion criteria based on clinical and radiological parameters.Results: Three-quarters of the patients were male. The mean age at the time of surgery was 39.3 ± 15.97 years. Falling was the leading cause for hand fractures, and the commonest were fractures of the shaft (>52%). More than 15% were complex hand injuries with more than one fractured finger. The majority of patients were healthy non-smokers without systemic diseases and relevant medical history. Conclusion: The Stryker Finger Plates are safe implants with good results that are consistent with those reported in the literature. The trend is also toward stable-angle implants for fracture treatment of the finger, in order to enable the earliest possible functional, safe mobilization. The maxim that the extent of the soft tissue injury is responsible for the result continues to apply.Level of Evidence Level: IV; Outcome-study, retrospective