bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Reference Axes for Femoral Component Rotation in Total Knee Arthroplasty
Authors: Jang Eugene S. , Connors-Ehlert Ronald , LiArno Sally , Geller Jeffrey A. , Cooper H. John , Shah Roshan P. 
Published: September 2019

Background:
Many reference axes are used to evaluate rotation of the femoral component during total knee arthroplasty, including the Whiteside line, surgical transepicondylar axis (sTEA), anatomical transepicondylar axis (aTEA), posterior condylar axis externally rotated 3° (PCA+3°ER), sulcus line, and femoral transverse axis (FTA). There is no consensus about which of these axes is most accurate.

Methods:
The Stryker Orthopaedic Modeling and Analytics (SOMA) database was used to identify 2,128 entire-femur computed tomography (CT) scans. The Whiteside line, aTEA, PCA+3°ER, sulcus line, and FTA were constructed according to published guidelines. Every axis was compared with the sTEA, which is widely regarded as the gold standard reference axis for rotation of the distal part of the femur but has low intraobserver and interobserver reliability intraoperatively.

Results:
The PCA+3°ER differed from the sTEA by a mean (and standard deviation) of 0.60° ± 1.64°; it was the most accurate but also had the highest degree of intersubject variability. The mean PCA-sTEA angle was 2.40°, close to the accepted “rule of thumb” of 3°. This value was significantly higher in women (2.64° ± 1.74°) than in men (2.18° ± 1.52°; p < 0.001). The Whiteside line differed from the sTEA by a mean of 1.90° ± 1.38°, and the sulcus line differed from the sTEA by a mean of 1.94° ± 1.49°; neither of these values varied significantly with sex or ethnicity. The FTA differed from the sTEA by a mean of 2.04° ± 1.50°. Least accurate was the aTEA, which differed from the sTEA by a mean of 2.05° ± 1.33°. The combination of 3 axes that are readily available intraoperatively (the Whiteside line, aTEA, and PCA+3°ER) differed from the sTEA by a mean of 1.80° ± 0.70°.

Conclusions:
In the largest study of its kind, analysis of CT scans of 2,128 femora revealed that no 1 axis could serve as a marker of femoral component rotation with both high accuracy and low variability. Utilizing a combination of 3 methods (PCA+3°ER, the Whiteside or sulcus line, and aTEA) to maximize accuracy and sex and ethnic generalizability when positioning the femoral component is recommended.

Clinical Relevance:
A large-scale study using a CT-based biomorphometric database demonstrated that use of a combination of 3 axes (PCA+3°ER, the Whiteside or sulcus line, and aTEA) was the optimal strategy for judging femoral component rotation.
The safety of restrictive fluid therapy for major abdominal surgery: a systematic review and meta-analysis
Authors: Author) Jiaxun Cai(Former Corresponding , Tang Zairong , Hu Fangyong , Fu Wenjie 
Published: September 2019

Abstract
Background: Restrictive fluid therapy is essential to enhanced recovery after surgery. A meta-analysis was conducted to explore the safety of restrictive fluid therapy for major abdominal surgery and compare it with liberal fluid therapy.
Methodology: We searched MEDLINE, the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs), the WHO International Clinical Trials Registry Platform, and EMBASE in which restrictive and liberal fluid therapies were compared. Data on complications, anastomotic leaks, and wound infections were extracted.
Results: Among the 472 articles selected from the databases, based on abstract reading, 272 articles were excluded according to the criteria in Figure 1. After reading the complete text, among the 78 remaining articles, excluded were 15 articles with no relevant data about the outcome of restrictive fluid therapy for major abdominal surgery, 54 that were not RCTs, 2 that were meta-analyses, and 7 that were from the same trial. Finally, 11 RCTs published between 2000 and 2018 that compared restrictive fluid therapy with liberal fluid therapy were included. Two studies by the same team were taken as one trial and shared the same study number because some data from the two studies were complementary.. Compared with liberal fluid therapy, restrictive fluid therapy lowered the risk of complications and cardiopulmonary dysfunction and had similar rates of mortality, anastomotic leak, pneumonia and would infection. But increased kidney injury was also observed in restrictive fluid therapy.
Conclusion: the current meta-analysis assessed the effects of restrictive fluid therapy in a meticulous way. Though the large proportional reduction in risk of complications as indicated in the previous literature was not confirmed, moderate but clinically notable reduction in complications is still worth our attention. The application of restrictive fluid therapy requires communication and cooperation between medical workers and patients. RCTs on restrictive fluid therapy with long-term follow-up are needed. Hospital costs and quality of life after surgery should also be taken into account. Furthermore, the benefits of restrictive fluid therapy in elderly patients and patients who have undergone other surgeries might be the focus of future research..
Assessment of homologous recombination deficiency phenotype in breast cancers in adolescents and young adults in the clinical setting
Authors: Watanabe Tomoko , Honda Takayuki , Totsuka Hirohiko , Yoshida Masayuki , Tanioka Maki , Shiraishi Kouya , Shimada Yoko , Arai Eri , Ushiama Mineko , Tamura Kenji , Yoshida Teruhiko , Kanai Yae , Kohno Takashi 
Published: September 2019

Abstract
Background Homologous recombination deficiency (HRD), which may be associated with high efficacy of PARP inhibitor- and platinum agent-based therapies, is a prevalent phenotype of breast cancer diagnosed in adolescents and young adults (AYAs; 15–39 years old). HRD score, indicating HRD status, is not routinely assessed in the oncology clinic due to the need for genome-wide analyses. Methods Subjects were a Japanese cohort of 46 AYA breast cancer patients, whose HRD scores were calculated from whole-exome sequencing data, and two existing breast cancer cohorts (US and European) for which HRD scores were available. Genetic and clinicopathological factors associated with the HRD-high phenotype, defined as HRD score ≥42, were selected based on the criterion that they be assessible by routine examinations qualifying for insurance reimbursement. A model for prediction of the HRD-high phenotype was constructed and validated using data from the three cohorts. Results In the Japanese AYA cohort, as in the US and European cohorts, HRD-high phenotype (13/46, 28.3%) was preferentially observed in cases with any or combination of germline BRCA1/2 mutations, somatic TP53 mutations, triple-negative subtype, and higher tumor grades. Because these four factors can be assessed by routine examination that qualifies for insurance reimbursement, we developed a model based on these factors to judge whether a case is HRD-high, using the US cohort (n = 744; Area under the curve [AUC] = 0.85). The predictive power of the model was validated in the Japanese (n = 46; AUC = 0.90) and European (n = 58; AUC = 0.96) AYA cases. A model developed using the European cohort (n = 477; AUC = 0.89) had similar predictive power in Japanese (AUC = 0.89) and US (n = 54; AUC = 0.87) AYA cohorts. Conclusions The HRD-high phenotype of AYA breast cancer can be deduced based on genomic and pathological factors that are routinely examined in the oncology clinic. The predictive model presented here could increase the fraction of AYA breast cancer patients who could benefit from PARP inhibitor­- and platinum agent-based therapies.
Anaerobic/aerobic integration via UASB/enhanced aeration for greywater treatment and unrestricted reuse
Authors: Abdel-Shafy Hussein I. , Mansour Mona S. M. , Al-Sulaiman Ahmed Makki 
Published: September 2019

Abstract
The aim of the present study is to achieve an efficient treatment of greywater for reuse in food crops' irrigation. For this purpose, anaerobic followed by enhanced aerobic treatment system was examined via both bench scale and pilot plant. The greywater was separated and collected from the source. The examined systems consisted of Up flow Anaerobic Sludge Blanket (UASB) followed by anaerobic aeration enhanced by Effective Microorganism (EM). The characteristics of the raw greywater were within a high strength level due to the presence of detergents, phosphates, oil and grease. The BOD5/COD was 0.75, showing that biological treatment to this greywater could be achieved. Treatment with UASB showed high elimination of oil & grease, BOD5, COD, total phosphates, and TKN in the range of 60 to 84%. However, TSS and ammonia were poorly removed. UASB effluent was further aerobically treated in a continuous aerated system where the predetermined optimum EM dose was added. Both aeration time and EM dose were previously examined to reach the optimum. Anaerobic/aerobic pilot plant in the continuing treatment was evaluated, where the final treated effluent successfully reached the permissible limits for unrestricted reuse according to the international regulation, namely FAO, WHO, US EPA and Egypt.
Pioglitazone Therapy Decreases Bone Mass Density and Increases Fat Mass: A Meta-Analysis
Authors: Zuo Liyun , Wang Jianbin , Zhang Nianping , Wang Junjie 
Published: September 2019

Background:
Pioglitazone is mainly used for the management of type 2 diabetes and other insulinassociated
diseases. However, the molecular mechanism of pioglitazone can lead to an imbalance in bone metabolism,
thus decreasing bone mass density (BMD) and increasing the risk for fractures.

Objective:
To demonstrate the effect of pioglitazone therapy on bone metabolism and fat mass.

Methods:
A comprehensive search of the PubMed, EMBASE, Web of Science and Cochrane Central databases
for randomized controlled trials (RCTs) on the effect of pioglitazone therapy on BMD and fat mass was performed.
The primary outcome measures were the measured values of BMD, percentage changes in BMD, measured
values of bone turnover markers and bone metabolic hormones, changes in BMI, body and leg fat mass, and
fracture rates. The final search was performed in May 2019.

Results:
Six RCTs were included. A total of 749 patients met the inclusion criteria. Pioglitazone therapy was
shown to significantly reduce the BMD of the whole body, lumbar spine, and total hip and serum PTH levels and
increase BMI, total body fat mass and leg fat mass. In addition, 30 mg/d and 30 mg/d initially for one month
followed by 45 mg/d pioglitazone could reduce the BMD of the lumbar spine. Pioglitazone therapy exerted no
significant influence on the BMD of the femoral neck, serum BSAP or 25-OHD levels, or fracture rates.

Conclusion:
Compared with placebo, pioglitazone therapy reduced BMD and serum PTH levels and increased fat
mass and BMI with no difference in serum BSAP or 25-OHD levels or fracture rates; 30 mg/d pioglitazone was
sufficient to reduce the BMD of the lumbar spine.
Prediction of RNA Secondary Structure Using Quantum-inspired Genetic Algorithms
Authors: Shi Sha , Zhang Xin-Li , Yang Le , Du Wei , Zhao Xian-Li , Wang Yun-Jiang 
Published: September 2019

Background:
The prediction of RNA secondary structure using optimization algorithms
is key to understand the real structure of an RNA. Evolutionary algorithms (EAs) are popular
strategies for RNA secondary structure prediction. However, compared to most state-of-the-art
software based on DPAs, the performances of EAs are a bit far from satisfactory.

Objective:
Therefore, a more powerful strategy is required to improve the performances of EAs
when applied to the prediciton of RNA secondary structures.

Methods:
The idea of quantum computing is introduced here yielding a new strategy to find all
possible legal paired-bases with the constraint of minimum free energy. The sate of a stem pool
with size N is encoded as a population of QGA, which is represented by N quantum bits but not
classical bits. The updating of populations is accomplished by so-called quantum crossover
operations, quantum mutation operations and quantum rotation operations.

Results:
The numerical results show that the performances of traditional EAs are significantly
improved by using QGA with regard to not only prediction accuracy and sensitivity but also
complexity. Moreover, for RNA sequences with middle-short length, QGA even improves the
state-of-art software based on DPAs in terms of both prediction accuracy and sensitivity.

Conclusion:
This work sheds an interesting light on the applications of quantum computing on
RNA structure prediction.
The Superior Mesenteric Artery: From Syndrome in the Young to Vascular Atherosclerosis in the Old
Authors: Beita Ana Karolina Víquez , Whayne Thomas F. 
Published: September 2019

:This review is directed at increasing awareness of two diverse rare upper gastrointestinal problems that occur at opposite ends of the age spectrum and are difficult to diagnose and treat. The Superior Mesenteric Artery Syndrome (SMAS) likely involves a young patient, especially female, and is especially associated with rapid weight loss, resulting in relative strangulation of the duodenum by a narrowing of the angle between the Superior Mesenteric Artery (SMA) and the aorta. On the other hand, atherosclerosis of the SMA is associated most likely with postprandial upper intestinal ischemia and abdominal pain occurs in the elderly at high risk for cardiovascular (CV) disease.:Medical management of the SMAS in the young involves good alimentation and weight gain to overall increase the intestinal fat pad. Medical management of SMA atherosclerotic ischemia in the elderly is directed at marked lipid lowering with atherosclerotic plaque stabilization or even regression.:If needed, surgery for SMAS can be attempted laparoscopically with duodenojejunoscopy which is the most popular procedure but there are also more conservative possibilities that avoid division of the duodenum. In addition, sometimes direct vision is needed to successfully operate on SMAS. If surgery is needed for SMA atherosclerotic ischemia, it is usually attempted endoscopically with angioplasty and stent placement.:Most important, in the case of these two rare clinical entities, is that the clinician have a suspicion of their presence when indicated so that the young or old patient can be spared unnecessary suffering and return to good health in a timely fashion.
Purification and Biochemical Characterization of Cysteine Protease from Baby Kiwi (Actinidia arguta)
Authors: Miyazaki-Katamura Sayaka , Yoneta-Wada Mio , Kozuka Miyuki , Sakaue Tomohisa , Yamane Takuya , Suzuki Junko , Arakawa Yoshihito , Ohkubo Iwao 
Published: September 2019

Background:It has recently been reported that the fruit, stems and leaves ofActinidia argutahave various potential health effects including an antioxidant effect, anticancer effect, anti-allergic effect and α-glucosidase inhibitory effect. However, little is known about the biochemical properties of cysteine protease in the fruit juice ofA. arguta.Methods:Ion exchange chromatography to purify the cysteine protease from the fruit juice ofA. arguta, and some synthetic substrates to determinate the enzyme activity were used.Results:Cysteine protease was purified to homogeneity fromA. argutafruit juice by ion exchange chromatography. The molecular weight of the purified enzyme was calculated to be approximately 25,500 by SDS-PAGE in the presence of β-ME. The enzyme rapidly hydrolyzed the substrate Z-Leu-Arg-MCA and moderately hydrolyzed other substrates including Boc-Val-Leu-Lys-MCA, Z-Val-Val-Arg-MCA and Z-Phe-Arg-MCA. Kinetic parameters for these four substrates were determined. TheKm,Vmax,KcatandKcat/Kmvalues for Z-Leu-Arg-MCA, the most preferentially cleaved by the enzyme, were 100 μM, 63.8 μmoles/mg/min, 27.26 sec-1and 0.2726 sec-1μM-1, respectively. Furthermore, the activity of the enzyme was strongly inhibited by inhibitors including antipain, leupeptin, E-64, E-64c, kinin-free-LMW kininogen and cystatin C. Those biochemical data indicated that the enzyme was a cysteine protease. The amino acid sequence of the first 21 residues of cysteine protease purified fromActinidia argutawas Val1-Leu-Pro-Asp-Tyr5-Val-Asp-Trp-Arg-Ser10-Ala-Gly-Ala-Val-Val15-Asp-Ile-Lys-Ser-Qln20-Gly. This sequence showed high homology to the sequences of actinidin fromAcinidia deliciosa(95.0%) and actinidin fromActinidia eriantha(90%). These three cysteine proteases were thought to be common allied species.Conclusion:The biochemical properties of the enzyme purified fromA. argutafruit juice were determined. These basic data are expected to contribute to the maintenance and improvement of human health as well as to the promotion of protein digestion and absorption through its proteolytic functions.
Mechanical and Tribological Characterization of Hybrid Natural Fiber Reinforced Composites
Authors: Parikh Hiral H. , Soni Harshit P. , Suthar Deval A. , Patel Dhruv H. 
Published: September 2019

Background:The technological enhancement in various disciplines enhances the demand for the new material which can replace the conventional materials. This has initiated the idea of composite materials. Synthetic fiber reinforced polymer matrix composites are being widely used due to its mechanical properties, but these fibers lack in terms of biodegradability, initial processing cost, recyclability and health hazard. An alternative to tackle these drawbacks can be found in natural fibers, that give an advantage in terms of strength to weight ratio, ease of availability and biodegradability.Methods:This work is aimed to determine the effect of hybrid basalt - banana reinforced epoxy composite and their effectiveness in substituting few conventional materials in terms of their mechanical properties, wear resistance and water absorption rate.Results:Basalt Banana Hybrid Composite (BBHC) is tested for their mechanical strength, hardness, impact strength, flexural strength, wear rate and water absorption rate. The test results of mechanical properties for the BBHC are compared to the other hybrid materials and conventional materials.Conclusion:The test results reveal that the hybrid basalt banana epoxy composite is a good substitute over various conventional materials. The water absorption test results reveal that the hydrophilic nature of the natural fibers reduces a lot after the hybridization.
Reasons for Antiretroviral Treatment Change Among Adult HIVAIDS Patients at Nedjo General Hospital, Western Ethiopia
Authors: Fekadu Ginenus , Bati Lencho , Gebeyehu Habte 
Published: September 2019

Background:Frequent change of Antiretroviral Treatment (ART) regimen is a challenging problem especially in a resource-limited setting like Ethiopia where treatment options are limited. This study was aimed to identify reasons for ART regimen change among adult HIV patients at Nedjo General Hospital (NGH).Methods:An institutional-based retrospective cross-sectional study was conducted at NGH by reviewing patient information cards from 2006 to 2016.Results:From a total of 117 included patients, 50.4% were females and the median (IQR) age of the patients was 28 (24-47) years. Majority of patients, 63 (53.9%) started their treatment at world health organization (WHO) clinical stage III (53.9%) and CD4 count of between 200-350 cells/mm3 (44.54%). At the beginning of ART, 56 (47.9%) patients were on a fixed-dose combination of stavudine-lamivudine-nevirapine (D4T/3TC/NVP). The single-drug substitutions were D4T (n = 63), NVP (n = 34), AZT (n =5), EFV (n = 2), and TDF (n = 1). Majority of the patients, 35(29.9%) switched their initial ART regimen after 3 years of regimen commencement. The common reasons reported for initial regimen change was availability of new drug 46 (39.3%) followed by toxicity/side effects 34 (29.2%). From all toxicities, peripheral neuropathy (47.1%) was the most common toxicity followed by rash (20.6%). After regimen change, 47 (40.2%) were received AZT+3TC+NVP.Conclusion:Availability of new drug and toxicity were the common reasons for regimen modifications. There should be updated guidelines, sustainable supply of affordable ART drugs, and effective laboratory materials to increase treatment success and minimize the toxicity of the drugs.
Do Gender Diversity Recommendations in Corporate Governance Codes Matter? Evidence from Audit Committees
Authors: Sultana Nigar , Cahan Steven F. , Rahman Asheq 
Published: September 2019

SUMMARY
Motivated by two opposing views, the limited supply view and the discrimination view, we examine the impact of gender diversity guidelines on the strength of the association between the presence of female audit committee members and audit quality. The limited supply view predicts that the effect of female audit committee members on audit quality would decrease after the guidelines were issued because they increased the demand for women directors without a commensurate increase in the supply of qualified women directors. The discrimination view predicts this relation would increase after the guidelines were issued since some firms would have abandoned their suboptimal hiring practices that favored men over better qualified women, resulting in higher quality firm-director matches as opportunities for women increase. Consistent with the limited supply view, we find that the positive association between audit committee gender diversity and audit quality weakened after gender diversity guidelines were introduced in Australia.
JEL Classifications: G38; M42; M48.
Data Availability: Data are available from the databases cited in the text.
Sumbangsih Pondok Pesantren Al-Amin Rejomulyo Kota Kediri Jawa Timur pada Masyarakat Pelajar di Sekitarnya
Authors: Huda Syamsul 
Published: September 2019

Abstract: The role of boarding schools is needed by the community. Astraditional social institutions, Pesantren Al-Amin has a very wide influence androoted to the people around him, especially in the village of Rejomulyo Kediri.Contribution in the form of boarding facilities and Islamic education to the communityenvironment. Results from this study are: (1). Activities and education in Al-Aminboarding school Rejomulyo Kediri is madrasah diniyah, al-Qur'an, al-Hadith, Tafsir,Akhlaq, Tawheed, Fiqh, Sufism, Nahwu, Shorof, and others, as well as other religiousactivities. (2). Facilities provided Pondok Pesantren al-Amin to the students in thesurrounding communities are free of charge for the students Rejomulyo Villageresidents, Hot spot areas, bulletin boards, social activities, and other intellectualactivities, as well as living facilities.Keywords: boarding school, Contribution, Education, Facility.
Abstrak: Peran pondok pesantren sangat dibutuhkan kehadirannya olehmasyarakat. Sebagai lembaga sosial tradisional, Pesantren Al-Amin mempunyaipengaruh yang sangat luas dan mengakar kepada masyarakat yang ada disekitarnya, khususnya di lingkungan Desa Rejomulyo Kota Kediri. Sumbangsihpondok pesantren dewasa ini sudah sampai ke dalam ranah fasilitas, danpendidikan agama Islam kepada masyarakat lingkungannya. Hasil dari penelitianini adalah: (1). Kegiatan dan pendidikan yang ada di pondok pesantren Al-AminRejomulyo Kota Kediri adalah madrasah diniyah, dengan mengkaji al-Qur’an, al-Hadis, Tafsir, Akhlaq, Tauhid, Fiqih, Tasawuf, Nahwu, Shorof, dan yang lain, sertakegiatan-kegiatan keagamaan lainnya. (2). Fasilitas yang diberikan PondokPesantren al-Amin terhadap masyarakat pelajar di sekitarnya adalah biaya gratisbagi para santri kalong warga Kelurahan Rejomulyo, Hot spot Area, Mading,Kegiatan sosial, dan kegiatan intelek yang lainnya, juga tidak ketinggalan adalahfasilitas tinggal.Kata Kunci: Pesantren, Sumbangsih, Pendidikan, Fasilitas.