A Population-Based Cost Analysis of Thoracoscopic Versus Open Lobectomy in Primary Lung Cancer.

BACKGROUND: Thoracoscopic lobectomy for primary lung cancer has become increasingly popular worldwide due to several advantages over open lobectomy including reduced pain, reduced length of hospital stay, and comparable oncologic outcomes. The costs of thoracoscopic versus conventional open lobectomy have been compared in several studies with variable results. We compared the costs of thoracoscopic versus open lobectomy in lung cancer patients in Taiwan. METHODS: Patients who underwent lobectomy for primary lung cancer from the Taiwan National Health Insurance Research Database (NHIRD) between 2004 and 2010 were identified. Patient characteristics, operative data, and costs for each part of the hospitalization for surgery and 30 days of care after discharge were analyzed. RESULTS: A total of 5366 patients with complete clinical data who underwent either conventional open lobectomy (n = 3166, 59 %) or thoracoscopic lobectomy (n = 2200, 41 %) for primary lung cancer were identified from the database. Compared with open lobectomy, thoracoscopic lobectomy was associated with younger age, less comorbidity, shorter anesthesia times, and reduced lengths of hospital stay. Total hospital costs, operative costs, and other costs were significantly higher in the thoracoscopic group. The 30-day after discharge costs were significantly lower in the thoracoscopic group. CONCLUSIONS: Thoracoscopic lobectomy for primary lung cancer in Taiwan was associated with higher total hospital costs but lower 30 days after discharge costs than open lobectomy. These differences may have resulted from higher operative and instrument costs in the thoracoscopic group.

Simulation of electrical rectification effect in two-dimensional MoSe2/WSe2lateral heterostructures.

Two-dimensional (2D) transition metal dichalcogenides lateral heterostructures exhibit excellent performance in electrics and optics. The electron transport of the heterostructures can be effectively regulated by ingenious design. In this study, we construct a monolayer MoSe2/WSe2lateral heterostructure, covalently connecting monolayer MoSe2and monolayer WSe2. Using the Extended Huckel Theory method, we explored current-voltage characteristics under varied conditions, including altering carrier density, atomic replacement and interface angles. Calculations demonstrate a significant electrical rectification ratio (ERR) ranging from 200 to 800. Additionally, Employing Density Functional Theory with non-equilibrium Green's function method, we investigated electronic properties, attributing the rectification effect to electronic state distribution differences, asymmetric transmission coefficients and band bending of projected local density of states. The expandability of the interfacial energy barrier enhances the rectification effect through adjustments in carrier concentration, atomic replacements and interface size. However, these enhancements introduce challenges such as increased electron-boundary scattering and reduced ambipolarity, resulting in a lower ERR. This study provides valuable theoretical insights for optimizing 2D electronic diode devices, offering avenues for precise control of the rectification effect.

The piRNA response to BmNPV infection in the silkworm fat body and midgut.

Bombyx mori nucleopolyhedrovirus (BmNPV) is a DNA virus that causes huge losses to the silkworm industry but the piRNA responses during BmNPV infection in the silkworm remain uninvestigated. Here, silkworm piRNA profiles of uninfected and BmNPV-infected fat body and midgut were determined by high-through sequencing in the early stages of BmNPV infection. A total of 2675 and 3396 genome-derived piRNAs were identified from fat body and midgut, respectively. These genome-derived piRNAs mainly originated from unannotated instead of transposon regions in the silkworm genome. In total, 572 piRNAs were associated with 280 putative target genes in fat body and 805 piRNAs with 380 target genes in midgut. Compared to uninfected tissues, 322 and 129 piRNAs were significantly upregulated in BmNPV-infected fat body and midgut, respectively. In addition, 276 and 117 piRNAs were significantly downregulated. Moreover, differentially expressed (DE) piRNAs during BmNPV infection differed significantly between fat body and midgut. Putative DE piRNA-targeted genes were associated with "response to stimulus" and "environmental information processing" in fat body after infection with BmNPV, which may indicate an active piRNA response to BmNPV infection in fat body. This study may lay the foundation for future research of the potential roles of the piRNA pathway and specific piRNAs in BmNPV pathogenesis.