bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and Sustainability of a Standardized Care Pathway Developed with Use of Lean Process Mapping for the Treatment of Patients Undergoing Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
Authors: Oetgen Matthew E. , Martin Benjamin D. , Gordish-Dressman Heather , Cronin Jessica , Pestieau Sophie R. 
Published: November 2018

Background:
Recent changes in health care have begun to shift the industry from a volume-based to a value-based focus. This shift has led to standardized care pathways that decrease care variability, improve outcomes, and decrease cost. Although numerous studies have described standardized pathways for adolescent idiopathic scoliosis (AIS), few have demonstrated sustainability. We report the effectiveness and sustainability of a standardized care pathway for patients undergoing posterior spinal fusion for AIS.

Methods:
A standardized care pathway was developed and implemented (in March 2015) at our pediatric hospital for all patients undergoing posterior spinal fusion for AIS. This pathway was developed with use of the Lean process mapping technique to create an evidence-based protocol for preoperative, operative, postoperative, and post-discharge care. The 44 patients managed prior to implementation of the pathway (pre-pathway group) were compared with the 169 patients managed after implementation (post-pathway group). The post-pathway group was divided into 5 cohorts, each representing a 6-month time period. Clinical outcomes (pain scores, medication requirements, transfusions) and efficiency metrics (length of stay) were used to determine pathway sustainability.

Results:
The pre-pathway group included patients managed in the 8 months prior to implementation (July 2014 to February 2015) and the post-pathway group included patients who underwent surgery from March 2015 to July 2017, divided into 5 cohorts representing 6 months each. Patients in the post-pathway group had lower postoperative pain scores, and used significantly less opioids at each time interval, compared with the pre-pathway group. Perioperative transfusion requirements and postoperative length of stay were significantly lower across all post-pathway cohorts compared with the pre-pathway group. There were no significant differences in clinical results among the 5 post-pathway cohorts.

Conclusions:
Implementation of a standardized care pathway developed with use of Lean process mapping demonstrated effective and sustained improvements to the care of patients with AIS, as well as decreased postoperative length of stay. These outcomes have been maintained over 2.5 years, indicating that high-quality care for patients with AIS undergoing spinal fusion can be achieved and sustained with use of a standardized care pathway.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Effect of acupuncture on insomnia in menopausal women: A Study protocol for a Randomized Controlled Trial
Authors: Li Shanshan , Yin Ping , Yin Xuan , Bogachko Anna , Liang Tingting , Lao Lixing , Xu Shifen 
Published: November 2018

Abstract
Background: China today has high occurrences of insomnia in perimenopausal women. Some studies have shown that acupuncture might be effective in treating primary insomnia and insomnia related to depression and stroke. Although there are some programs supporting insomnia during the menopausal transition, there are few randomized controlled trials to provide evidence regarding their effectiveness. We design a randomized controlled trial of suitable sample size to verify the effectiveness of acupuncture in patients with insomnia during the menopausal transition and to form an optimized acupuncture treatment protocol.

Method/Design: In this randomized, single-site, single-blind, placebo-controlled trial, 84 eligible patients will be recruited and randomly assigned to either the acupuncture group (n = 42) or the sham control group (n = 42) in a 1:1 ratio. Participants will receive a total of 18 sessions of treatment for eight consecutive weeks. Treatments will be given three times per week in the first four weeks, twice a week for the next two weeks and finally treatment once weekly for the final two weeks. Treatment will utilize eight main acupoints (GV20, GV24, GV29, RN6, RN4, SP6, HT7, EX-HN22), and extra two acupoints based on syndrome differentiation. The primary outcome will be assessed using the Pittsburgh Sleep Quality Index (PSQI). The secondary outcomes will be measured by sleep parameters recorded in the Actigraphy (SE, TST, SA), Insomnia Severity Index (ISI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Menopause Quality of Life (Men-QOL). The primary outcomes will be assessed at baseline, week four, week eight, and first and the third month following the end of treatment.
Discussion: If the results confirm that acupuncture is effective and safe for the treatment on insomnia in menopausal women, this positive outcome could provide evidence for clinical application.
Water quality before and after a campaign of cleaning and disinfecting shallow wells: a study conducted during and after floods in Khyber Pakhtunkhwa, Pakistan
Authors: Ali Rashid , Bünzli Marc-André , Colombo Luca , Khattak Seema Anjum , Pera Sebastián , Riaz Mohammad , Valsangiacomo Claudio 
Published: November 2018

Abstract
This study reports on a water quality assessment of the Water, Sanitation and Hygiene program implemented by the Swiss Agency for Development and Cooperation in the districts of Charsadda and Nowshera in Khyber Pakhtunkhwa, Pakistan, in the aftermath of the severe flood of 2010. During emergency operations, over 4,500 shallow wells were cleaned using the standard protocol suggested by the World Health Organization. Bacteriological analysis and chemical-physical parameters such as temperature, conductivity, turbidity and pH were tested before and after cleaning. Four to five years after the emergency operation, in 2014–15, a set of 105 representative wells was analyzed again, considering the same parameters and looking for additional contaminants (pesticides, arsenic and fluoride). The post-flood well-cleaning campaign was effective in the immediate reduction of fecal contamination of water (from 85% to 20% as measured 7–30 days after cleaning); however in the following months/years the rate of fecal contamination rose again (up to 62% of all measured domestic wells, n = 105). Along with laboratory analysis data, this study investigated the source of contamination of shallow wells and identified human practices in several cases. This information was useful for the design of future SDC interventions in the WASH sector.
Assessing the impacts of climate change on the high altitude snow- and glacier-fed hydrological regimes of Astore and Hunza, the sub-catchments of Upper Indus Basin
Authors: Farhan Suhaib Bin , Zhang Yinsheng , Aziz Adnan , Gao Haifeng , Ma Yingzhao , Kazmi Jamil , Shahzad Atif , Hussain Iqtidar , Mansha Muhammad , Umar Mudassar , Nasir Jawad , Shafiq Muhammad , Farhan Yasir , Shaikh Saima , Zamir Umair Bin , Asad Fayyaz , Ahmed Raheel 
Published: November 2018

Abstract
Evaluation of the impacts of prevailing climate change on rivers and water resources is significantly important in order to successfully manage water resources, particularly in snow-fed and glacier-fed catchments. The basic aim of this research was to assess the impacts of climatic variability on Astore and Hunza river-flows by employing long-term in-situ hydro-meteorological data. Times-series analysis of high- and low-altitude station data revealed consistent summer cooling, and warming in winter and spring seasons in both Karakoram and western Himalayan basins of Hunza and Astore, respectively. The intensity of these changes was not found to be identical in both basins, i.e. Hunza depicts slightly higher summer cooling rates and slightly lower annual, winter and spring warming rates as compared to Astore. Subsequently, the significant increase in annual precipitation of Hunza was also not found to be identical with Astore precipitation, which shows only a slight increase of precipitation. Notwithstanding, comparable temperature trends were observed at both high- and low-altitude stations; however, on the contrary, precipitation shows a different pattern of behavior, i.e. significantly increased winter precipitation at high-altitude Astore stations was in contrast to the precipitation recorded by low-altitude stations. The study suggested that climate change is significantly influencing the characteristics and hydrological resources of this region.
Detecting Personalized Determinants During Drug Treatment from Omics Big Data
Authors: Wang Lu , Yu Xiangtian , Zhang Chengming , Zeng Tao 
Published: November 2018

Backgrounds: Targeted therapy is the foundation of personalized medicine in cancer, which is often
understood as the right patient using the right drug. Thinking from the viewpoint of determinants during personalized
drug treatment, the genetics, epigenetics and metagenomics would provide individual-specific biological
elements to characterize the personalized responses for therapy.

Methods:
Such personalized determinants should be not only understood as specific to one person, while they
should have certain replicate observations in a group of individuals but not all, which actually provide more
credible and reproducible personalized biological features. The requirement of detecting personalized
determinants is well supported by novel high-throughput sequencing technologies and newly temporal-spatial
experimental protocols, which quickly produce the omics big data.

Results:
In this mini-review, we would like to give a brief introduction firstly on the advanced drug or drug-like
therapy with genetics, epigenetics and metagenomics, respectively, from the viewpoint of personalized
determinants; then summarize the computational methods helpful to analyze the corresponding omics data under
the consideration of personalized biological context; and particularly focus on metagenomics to discuss current
data, method, and opportunity for personalized medicine.

Conclusion:
Totally, detecting personalized determinants during drug treatment from omics big data will bring
the precision medicine or personalized medicine from concept to application. More and more inspiring biotechnologies,
data resources, and analytic approaches will benefit All of US in the near future.
Design and Synthesis of the Diazirine-based Clickable Photo-affinity Probe Targeting Sphingomyelin Synthase 2
Authors: Wang Penghui , Li Zhining , Jiang Lulu , Zhou Lu , Ye Deyong 
Published: November 2018

Background:SMS family plays a very important role in sphingolipids metabolism and is involved in the membrane mobility and signaling transduction.Methods:SMS2 subtype was related to a variety of diseases and could be regarded as a promising potential drug target. However, the uncertainty of the binding sites and the molecular mechanism of action limited the development of SMS2 inhibitors. Herein, we discovered a photo-affinity probe PAL-1 targeting SMS2.Results:The enzyme inhibitory activity and the photo-affinity labeling experiments showed that PAL-1 could be mono-labeled on SMS2.Conclusion:In summary, starting from the N-arylbenzamides core structure and the minimalist terminal alkyne-containing diazirine photo-crosslinker, we designed and synthesized a photoaffinity probe PAL-1 targeting SMS2. The enzymatic inhibitory activity study showed that PAL-1 exhibited superior selectivities for SMS2 with an IC50 of 0.37 µM over SMS1.
Production of Rhamnolipid Biosurfactant from Fed Batch Culture by Pseudomonas aeruginosa using Multiple Substrates
Authors: Eswari Jujjavarapu S. 
Published: November 2018

Objective:
Biosurfactants are the surface active agents which are used for the reduction of
surface and interfacial tensions of liquids. Rhamnolipids are the surfactants produced by Pseudomonas
aeruginosa. It requires minimum nutrition for its growth as it can also grow in distilled water.
The rhamnolipids produced by Pseudomonas aeruginosa are extra-cellular glycolipids consisting of
L-rhamnose and 3-hydroxyalkanoic acid.

Methods:
The fed-batch method for the rhamnolipid production is considered in this study to know
the influence of the carbon, nitrogen, phosphorous substrates as growth-limiting nutrients. Pulse
feeding is employed for limiting nutrient addition at particular time interval to obtain maximum
rhamnolipid formation from Pseudomonas aeruginosa compared with the batch process.

Results:
Out of 3 fed batch strategies constant glucose fed batch strategy shows best and gave maximum
rhamnolipid concentration of 0.134 g/l.
Quality Characteristics of Rotative-type Biscuits Free of Gluten Prepared with Soya Flour and Cassava Starch
Authors: Dahmer Alice Maria , Rigo Aline Andressa , Valduga Eunice , Steffens Juliana , Steffens Clarice , Carrão-Panizzi Mercedes Concordia 
Published: November 2018

Background:
The objective of this work was to develop rotative-type biscuits, replacing
wheat flour with alternative ingredients without gluten, made from soy flour and cassava starch.

Methods:
Three formulations with different concentrations of soy flour (9.28-18.55% m/m) and cassava
starch (27.83-37.10% m/m) were made. The biscuit formulations were evaluated in relation to
physical, chemical, microbiological and sensorial characteristics.

Results:
In the present study, the rotative-type biscuit formulations containing soy flour and cassava
starch were elaborated without the wheat proteins, responsible for the formation of the gluten network,
presented typical and desirable characteristics such as hardness and color, in addition to a good
yield and increase in protein, minerals, lipids and fiber contents and with an acceptability greater than
70%. It is possible to add around 14-18% of soy flour and 27-32% of cassava starch, without affecting
the technological characteristics and nutritional properties of the product.

Conclusion:
Rotative-type biscuits employ a simple processing technology and low cost, using soy
flour and cassava starch and are alternatives to gluten-free products.
Small Molecular Leads Differentially Active Against HER2 Positive and Triple Negative Breast Cancer Cell Lines
Authors: Badran Adnan , Atia-tul-Wahab  , Fayyaz Sharmeen , Baydoun Elias , Choudhary Muhammad Iqbal 
Published: November 2018

Background:Breast cancer is the most prevalent cancer type in women globally. It is characterized by distinct subtypes depending on different gene expression patterns. Oncogene HER2 is expressed on the surface of cell and is responsible for cell growth regulation. Increase in HER2 receptor protein due to gene amplification, results in aggressive growth, and high metastasis in cancer cells.Methods:The current study evaluates and compares the anti-breast cancer effect of commercially available compounds against HER2 overexpressing BT-474, and triple negative MDA-MB-231 breast cancer cell lines.Results:Preliminary in vitro cell viability assays on these cell lines identified 6 lead molecules active against breast cancer. Convallatoxin (4), a steroidal lactone glycoside, showed the most potent activity with IC50 values of 0.63 ± 0.56, and 0.69 ± 0.59 µM against BT-474 and MDA-MB-231, respectively, whereas 4-[4-(Trifluoromethyl)-phenoxy] phenol (3) a phenol derivative, and Reserpine (5) an indole alkaloid selectively inhibited the growth of BT-474, and MDA-MB-231 breast cancer cells, respectively.Conclusion:These results exhibited the potential of small molecules in the treatment of HER2 amplified and triple negative breast cancers in vitro.
3, 3-Dimethylquercetin Inhibits the Proliferation of Human Colon Cancer RKO Cells through Inducing G2/M Cell Cycle Arrest and Apoptosis
Authors: Wu Jianguo , Yi Jun , Wu Yanbin , Chen Xuzheng , Zeng Jianwei , Wu Jinzhong , Peng Wei 
Published: November 2018

Background:
Our previous study successfully identified that 3,3-Dimethylquercetin (DMQ) acted
as a potent anticancer agent against human colon cancer cell lines RKO. Thus, this study was conducted to investigate
the underlying mechanism by which DMQ displayed inhibitory activity in RKO cells.

Methods:
Flow cytometry was used to evaluate the effect of DMQ on the cell cycle arrest, as well as the mitochondrial
membrane potential in RKO cells. DAPI staining and DNA fragmentation ladder assays were performed
to assess the apoptosis inducing activity of DMQ. Furthermore, western blot analysis was conducted to
examine the expression of related proteins responsible for the cell cycle arrest and apoptosis.

Results:
Treatment with DMQ caused a significant increase in the fraction of G2/M cells, and induced remarkable
apoptosis. Furthermore, western blot analysis showed that DMQ arrested cells at G2/M checkpoint by
down-regulation of cyclin B1, cdc2 and cdc25c and up-regulation of p21, and induced cell apoptosis via affecting
the ratio of Bax/Bcl-2, causing loss of the mitochondrial membrane potential and enhancing the expression
of cleaved caspase-9 (C-caspase-9) and cleaved caspase-3 (C-caspase-3).

Conclusion:
These data showed that DMQ could suppress RKO cell growth by arresting RKO cells at G2/M
checkpoint and inducing mitochondria-dependent cell apoptosis. Our findings shed light on the potential use of
DMQ as a chemotherapeutic agent for CRC.
Efficacy of Celecoxib Adjunct Treatment on Bipolar Disorder: Systematic Review and Meta-Analysis
Authors: Bavaresco Daniela V. , Colonetti Tamy , Grande Antônio J. , Colom Francesc , Valvassori Samira S. , Quevedo João , da Rosa Maria I. 
Published: November 2018

Background:
Bipolar Disorder (BD) is a psychiatric disorder characterized by mood disturbances.
The pathophysiology of BD is still poorly understood. In the last years, research studies focused
on the role of inflammation in BD.

Objective:
Performed a systematic review and meta-analysis to evaluate the potential effect of the cyclo-
oxygenases (Cox)-2 inhibitor Celecoxib adjunct treatment in BD through randomized controlled
trials (RCT).

Methods:
A search on the electronic databases was proceeded, on MEDLINE, EMBASE, Scopus,
Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, Web of Science,
IBECS, LILACS, PsycINFO, Congress Abstracts, and Grey literature (Google Scholar and the British
Library) for studies published from January 1990 to February 2018. A search strategy was developed
using the terms: “Bipolar disorder” or “Bipolar mania” or “Bipolar depression” or “Bipolar mixed” or
“Bipolar euthymic” and “Celecoxib” or “Cyclooxygenase-2 inhibitors” or “Cox-2 inhibitors” as text
words and Medical Subject Headings (i.e., MeSH and EMTREE) and searched. The therapeutic effects
of adjunctive treatment with Celecoxib were analyzed. The meta-analysis was performed including the
results of the Young Mania Rating Scale (YMRS) at the end of RCT.

Results:
Three primary studies were included in the systematic review, with a total of 121 patients.
The meta-analysis showed a significant effect on the YMRS scores from patients with BD who used
Celecoxib adjuvant treatment in comparison to placebo.

Conclusion:
The systematic review suggests that adjuvant treatment with Celecoxib improves the response
of major treatments in patients with BD when compared with adjuvant placebo treatment.

Systematic Review Registration Number:

The review protocol was registered at PROSPERO (registration
number: CRD42017067635); in June 06 2017.
Irreparable Rotator Cuff Tears Without Arthritis Treated With Reverse Total Shoulder Arthroplasty
Authors: Virk Mandeep S. , Nicholson Gregory P. , Romeo Anthony A. 
Published: November 2018

Background:
Irreparable rotator cuff (RC) tears without arthritis is a challenging clinical problem in young adults. Reverse total shoulder arthroplasty (RTSA) has been proposed as one of the surgical treatment options for this condition.

Methods:
In this review, we discuss the current understanding of the role of RTSA for the management of irreparable RC tears without arthritis based on authors personal experience and available scientific literature.

Results:
Reverse total shoulder arthroplasty (RTSA) is a constrained arthroplasty system that can allow the deltoid and remaining rotator cuff to substitute for the lost function of irreparable RC. Furthermore, the pain relief is consistent with often a dramatic improvement in patient comfort, shoulder function and stability. In patients with pseudoparalysis of the shoulder without advanced arthritis, RTSA effectively restores forward elevation above the shoulder but may not dramatically improve external (ER) or internal rotation (IR). However, due to concerns over implant longevity, caution has to be exercised when using RTSA for symptomatic irreparable RC tears with preserved active forward elevation (AFE) and in patients less than 65 years of age.

Conclusion:
RTSA is a reasonable surgical option for irreparable rotator cuff repair without arthritis. However, caution should be exercised when offering RTSA to young patients and patient without pseudoparalysis because they can have a higher complication and dissatisfaction rate. In addition, longevity of RTSA and subsequent need for revision surgery remains a significant concern in this population.
Design and Development of Wireless Control System Architecture for ITER-India Gyrotron Test Facility
Authors: Mandge Deepak , Gajjar Nagendra Prakash 
Published: November 2018

Background & Objective:
Wireless networks are making its way for use in industrial control
system applications. The installation of Wireless networks naturally provides a reduction in cable
and its maintenance related costs, provides increased flexibility and mobility to enhance the performance
of industrial control system.

Method:
This paper attempts to show the suitability of a wireless network in control system application
of ECRH system at IIGTF. IEEE 802.11n network is implemented to interface field instruments
with PLC based control system in an industry like environment. The two case studies with different
control architecture are implemented with satisfactory test results. The first case demonstrates the use
of a wireless network for monitoring and data acquisition of cooling water process parameters. The
second case implements the control and monitoring of the DC power supply over the wireless network
through a serial ASCII protocol. The performance of wireless communication alone in is evaluated
using theoretical analysis, simulation and actual field measurement. Then overall performance
of the case studies including field signals and PLC system is evaluated.

Conclusion:
The PLC application logic is developed for the implementation of logic functions to interface
various field instruments and power supply. The DC power supply is simulated using Labview
™ for serial ASCII communication. The above said concept is proposed for the Local Control
Unit being developed for ITER-India Test Gyrotron Facility.