bluuebunny/crossref_metadata_2025_split huggingface dataset:
GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community
Authors: Cederholm T. , Jensen G.L. , Correia M.I.T.D. , Gonzalez M.C. , Fukushima R. , Higashiguchi T. , Baptista G. , Barazzoni R. , Blaauw R. , Coats A.J.S. , Crivelli A.N. , Evans D.C. , Gramlich L. , Fuchs‐Tarlovsky V. , Keller H. , Llido L. , Malone A. , Mogensen K.M. , Morley J.E. , Muscaritoli M. , Nyulasi I. , Pirlich M. , Pisprasert V. , de van der Schueren M.A.E. , Siltharm S. , Singer P. , Tappenden K. , Velasco N. , Waitzberg D. , Yamwong P. , Yu J. , Van Gossum A. , Compher C. ,   GLIM Core Leadership Committee, GLIM Working Group
Published: March 2019

SummaryRationaleThis initiative is focused on building a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings.MethodsIn January 2016, the Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. GLIM appointed a core leadership committee and a supporting working group with representatives bringing additional global diversity and expertise. Empirical consensus was reached through a series of face‐to‐face meetings, telephone conferences, and e‐mail communications.ResultsA two‐step approach for the malnutrition diagnosis was selected, i.e., first screening to identify “at risk” status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among the GLIM core and supporting working group members. The top five ranked criteria included three phenotypic criteria (weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present. Phenotypic metrics for grading severity as Stage 1 (moderate) and Stage 2 (severe) malnutrition are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology‐related diagnosis categories.ConclusionA consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure further collaboration and endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The diagnostic construct should be re‐considered every 3–5 years.
Symptomatic severe hypophosphatemia after intravenous ferric carboxymaltose
Authors: Fang Wendy , McMahon Lawrence P , Bloom Stephen , Garg Mayur 
Published: March 2019

Intravenous iron is commonly prescribed for treatment of iron deficiency, with modern formulations demonstrating an acceptable safety profile in the majority of patients. We report the case of a patient who was hospitalised with muscle pain, deteriorating mobility and multiple fractures following repeated ferric carboxymaltose infusions. Investigations revealed severe hypophosphatemia with serum phosphate of 0.27 mmol/L, 25‐hydroxyvitamin D (25OHD) level of 32 nmol/L and insufficiency fractures of the sacrum and L5 transverse process. The patient's hypophosphatemia was corrected with several infusions of intravenous phosphate, as well as oral phosphate and calcitriol, with subsequent resolution of her muscle aches, back pain and immobility.The risk of persistent hypophosphatemia and osteomalacia may be higher with iron carboxymaltose than other iron formulations and a transient increase in intact fibroblast growth factor‐23 with reduced renal tubular phosphate absorption has been postulated as the key mechanism. This risk appears increased by repeated iron infusions, underlying malnutrition, hypophosphatemia at baseline, vitamin D deficiency, hyperparathyroidism or anti‐resorptive medication use. The true risk and incidence of hypophosphatemia need to be clarified so that appropriate monitoring, prevention and treatment strategies can be developed.
Effects of duration of initial treatment on postoperative complications in pancreatic cancer
Authors: Yamada Suguru , Takami Hideki , Sonohara Fuminori , Hayashi Masamichi , Fujii Tsutomu , Kodera Yasuhiro 
Published: March 2019

AbstractBackgroundWe analyzed the clinical impact of chemotherapy or chemoradiotherapy as initial treatment (IT), focusing on treatment duration, on morbidity and mortality in patients with resected pancreatic ductal adenocarcinoma.MethodsWe enrolled 509 consecutive patients, with 417 in the upfront surgery group and 92 in the IT group. The IT group was subdivided into 72 patients treated for <8 months and 20 treated ≥8 months. We compared rates of postoperative Clavien–Dindo grade ≥III complications between the groups. Multivariate logistic regression analysis was used to find independent predictors of complications.ResultsThe upfront surgery and IT groups did not significantly differ in overall postsurgical complications. In contrast, rates of overall complications significantly differed between the <8 months and ≥8 months IT groups, although their background clinical factors did not differ. In multivariate analysis, operative procedure (distal pancreatectomy and distal pancreatectomy with celiac axis resection) (odds ratio [OR] 6.950, P = 0.0416) and IT ≥8 months (OR 4.508, P = 0.0156) were independent predictive factors for postoperative complications.ConclusionsPostoperative complications were significantly higher in the ≥8 months IT group, and multivariate analysis demonstrated that operative procedure and ≥8 months IT were independent predictive factors.
Monoexponential, Biexponential, and stretched‐exponential models using diffusion‐weighted imaging: A quantitative differentiation of breast lesions at 3.0T
Authors: Jin Ya‐Nan , Zhang Yan , Cheng Jing‐Liang , Zheng Dan‐Dan , Hu Ying 
Published: March 2019

BackgroundDiffusion‐weighted imaging (DWI) plays an important role in the differentiation of malignant and benign breast lesions.PurposeTo investigate the utility of various diffusion parameters obtained from monoexponential, biexponential, and stretched‐exponential DWI models in the differential diagnosis of breast lesions.Study TypeProspective.PopulationSixty‐one patients (age range: 25–68 years old; mean age: 46 years old) with 31 malignant lesions, 42 benign lesions, and 28 normal breast tissues diagnosed initially by clinical palpation, ultrasonography, or conventional mammography were enrolled in the study from January to September 2016.Field Strength3.0T MR scanner, T1WI, T2WI, DWI (conventional and multi‐b values), dynamic contrast‐enhanced.AssessmentThe apparent diffusion coefficient (ADC) was calculated by monoexponential analysis. The diffusion coefficient (ADCslow), pseudodiffusion coefficient (ADCfast), and perfusion fraction (f) were calculated using the biexponential model. The distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained using a stretched‐exponential model. All parameters were compared for malignant tumors, benign tumors, and normal breast tissues. A receiver operating characteristic curve was used to compare the ability of these parameters, in order to differentiate benign and malignant breast lesions.Statistical TestsAll statistical analyses were performed using statistical software (SPSS).ResultsADC, ADCslow, f, DDC, and α values were significantly lower in malignant tumors when compared with normal breast tissues and benign tumors (P < 0.05). However, ADC and f had higher area under the receiver operating characteristic curve (AUC) values (0.889 and 0.919, respectively).Data ConclusionThe parameters derived from the biexponential and stretched‐exponential DWI could provide additional information for differentiating between benign and malignant breast tumors when compared with conventional diffusion parameters.Level of Evidence: 4Technical Efficacy: Stage 4J. Magn. Reson. Imaging 2019;50:1461–1467.
Neuroepigenetics of arousal: Gamma oscillations in the pedunculopontine nucleus
Authors: Garcia‐Rill Edgar 
Published: March 2019

AbstractFour major discoveries on the function of the pedunculopontine nucleus (PPN) have significantly advanced our understanding of the role of arousal in neurodegenerative disorders. The first was the finding that stimulation of the PPN‐induced controlled locomotion on a treadmill in decerebrate animals, the second was the revelation of electrical coupling in the PPN and other arousal and sleep–wake control regions, the third was the determination of intrinsic gamma band oscillations in PPN neurons, and the last was the discovery of gene transcription resulting from the manifestation of gamma activity in the PPN. These discoveries have led to novel therapies such as PPN deep brain stimulation (DBS) for Parkinson’s disease (PD), identified the mechanism of action of the stimulant modafinil, determined the presence of separate mechanisms underlying gamma activity during waking versus REM sleep, and revealed the presence of gene transcription during the manifestation of gamma band oscillations. These discoveries set the stage for additional major advances in the treatment of a number of disorders.
Responses of wheat to zinc sulfate fertilizer and plant growth‐promoting rhizobacteria under cadmium stress in soil
Authors: Safari Marzieh , Alishah Farzaneh Nahari , Dolatabad Hossein Kari , Ndu Udonna , Schulthess Cristian P. , Sorooshzadeh Ali 
Published: March 2019

AbstractCadmium (Cd) is a major pollutant in soils as a result of extensive use of fertilizers, mining and industrial discharges. Zinc (Zn) and certain bacterial species have been known to alleviate Cd toxicity in plants. In this study, the individual and combined effects of the application of Zn and Pseudomonas species with the aim of reducing Cd stress in wheat cultivars were investigated. Plants (durum wheat and bread wheat) were exposed to different concentrations of Cd and Zn, and either P. putida or P. fluorescens in a growth chamber. Concentrations of Zn, Cd, chlorophyll (Chl), carotenoid, hydrogen peroxide (H2O2), and malondialdehyde (MDA), as well as antioxidant enzyme activities were assayed. The addition of Zn in soils reduced the toxicity of Cd in durum wheat more than in bread wheat even though there was more uptake of Zn in bread wheat. Analysis of variance showed that by using Zn fertilizer and Pseudomonas species the amounts of peroxidase (POD), polyphenoloxidase (PPO), MDA, and H2O2 were reduced at three growth stages. Surprisingly, with increasing Zn concentration, Cd concentration in plant tissue was slightly increased, which suggests that adding Zn to soil could facilitate Cd desorption from soil particles. Application of Pseudomonas and Zn could be a promising solution to reduce detrimental effects of Cd, especially in durum wheat.
Spatially tracking carbon through the root–rhizosphere–soil system using laser ablation‐IRMS
Authors: Denis Elizabeth H. , Ilhardt Peter D. , Tucker Abigail E. , Huggett Nicholas L. , Rosnow Joshua J. , Moran James J. 
Published: March 2019

AbstractThe intimate relationships between plant roots, rhizosphere, and soil are fostered by the release of organic compounds from the plant into soil through various forms of rhizodeposition and the simultaneous harvesting of nutrients from the soil to the plant. Here we present a method to spatially track and map the migration of plant‐derived carbon (C) through roots into the rhizosphere and surrounding soil using laser ablation‐isotope ratio mass spectrometry (LA‐IRMS). We used switchgrass microcosms containing soil from field plots at the Kellogg Biological Station (Hickory Corners, Michigan, USA) which have been cropped with switchgrass since 2008. We used a 13CO2 tracer to isotopically label switchgrass plants for two diel cycles and tracked subsequent movement of labeled C using the spatially specific (< 100 µm resolution) δ13C analysis enabled by LA‐IRMS. This approach permitted assessment of variable C flow through different roots and enabled mapping of spatial variability of C allocation to the rhizosphere. Highly 13C‐enriched C (consistent with production during the 13CO2 application period) extended ≈ 0.5–1 mm from the root into the soil, suggesting that the majority of recent plant‐derived C was within this distance of the root after 48 h. Tracking the physical extent of root exudation into the rhizosphere can help evaluate the localization of plant‐microbe interactions in highly variable subsurface environments, and the use of the isotopic label can differentiate freshly fixed C (presumably from root exudates) from other types of subsurface C (e.g., plant necromass and microbial turnover). The LA‐IRMS technique may also serve as a valuable screening technique to identify areas of high activity for additional microbial or geochemical assays.
Modified normalization method in in vivo stratum corneum analysis using confocal Raman microscopy to compensate nonhomogeneous distribution of keratin
Authors: Choe Chunsik , Choe Sehyok , Schleusener Johannes , Lademann Jürgen , Darvin Maxim E. 
Published: March 2019

AbstractThe quantitative determination of substance concentration in the stratum corneum (SC) is important for profiling of the skin barrier function‐related parameters and for investigating drug delivery through the SC. Hereby, confocal Raman microscopy (CRM) is a widely used method, which can be applied noninvasively and in vivo. Most analysis methods are based on the assumption that keratin is distributed homogeneously throughout the SC. In this study, the depth profiles of keratin‐related Raman peaks (1,003, 1,450, 1,650, and 2,935 cm−1) are investigated in detail. It was shown that each of these Raman peaks can be used for the precise determination of the skin surface position, which is important in case of overlapping of these with Raman bands associated to a formulation for treated skin. For correction of the depth‐dependent signal attenuation, that is, normalization, the 1,450, 1,650, and 2,935 cm−1 peaks can be used, whereas the 1,003 cm−1 peak cannot. Further analysis shows that the keratin concentration is nonhomogeneous throughout the SC and decreases towards its bottom due to water increase. Thus, the concentration of certain substances in the SC, such as urea, lipids, water, or natural moisturizing factor, determined using normalization on the keratin peak intensity, is overestimated in the deep SC layers starting from 30% SC depth. The correction coefficients were calculated for all four Raman peaks and for all SC depths with 10% increments. It was determined that at the bottom of the SC, the values obtained using keratin normalization should be multiplied by 0.88 (for 1,003 or 1,450 cm−1), 0.94 (for 1,650 cm−1), and 0.92 (for 2,935 cm−1) in order to compensate nonhomogeneous distribution of keratin in the SC. Thus, original values are overestimated at the SC bottom by 6–12%. The presented correction mechanism is proposed to be used for further correction.
A comparison of the chemical composition and antioxidant activity of several new early‐ to mid‐season apple cultivars for a warmer climate with traditional cultivars
Authors: Kim Inhwan , Ku Kyung‐Hyung , Jeong Moon‐Cheol , Kim Sang Seop , Mitchell Alyson E , Lee Jihyun 
Published: March 2019

AbstractBackgroundNew early‐ to mid‐season apple cultivars are being developed to help address warmer growing seasons due to climate change. Free sugars, organic acids, total phenolic content, total flavonoid content, antioxidant activity and phenolic composition were determined in the pulp and peel of six new and six traditional apple cultivars. In addition, the phenolic profiles of apple peels were characterized using high‐resolution mass spectrometry. Forty‐eight polyphenol compounds were identified, by accurate mass, in apple peel.ResultsCompared to Fuji apples, a new apple cultivar, Decobell, contained 2.6‐ and 1.4‐fold higher levels of the sum of individual polyphenol levels in the peel and the pulp, respectively. Decobell apples showed similar sugar‐to‐acid ratio (0.27) to Fuji apples (0.25).ConclusionsThe results indicate that the Decobell cultivar could have the best quality characteristics in terms of sugar‐to‐acid ratios and health‐promoting activities due to the phenolic profiles. © 2019 Society of Chemical Industry
Variant hepatic arterial anatomy encountered during pancreatoduodenectomy does not influence postoperative outcomes or resection margin status: A matched pair analysis of 105 patients
Authors: Alexakis Nicholas , Bramis Konstandinos , Toutouzas Konstandinos , Zografos George , Konstadoulakis Manoussos 
Published: March 2019

AbstractBackground/AimAnatomic vascular abnormalities of the hepatic arteries are frequent. The aim of the study was to analyze the influence of hepatic arterial variations on postoperative morbidity and resection margin status after pancreatoduodenectomy (PD).Materials/MethodsPatients who underwent PD over a 7‐year period (2010‐2017) were included in the study. Patients with variant hepatic arterial anatomy were matched 1:2 for age, sex, ASA score, and histology.ResultsA total of 232 patients underwent PD. Variant hepatic arterial anatomy was found in 35 (15.1% of the total patient population). The most common variation was an accessory right hepatic artery (8.19%) and a replaced right hepatic artery (5.60%) arising from the superior mesenteric artery. These 35 patients were compared with 70 patients with no hepatic artery variations. Postoperative surgical complications occurred in 12.1% and 26.5% (P = 0.08) and in‐hospital mortality was 6% and 5.4% (
P = 0.99) between patients with and without variant hepatic arteries. There was no difference in positive resection margins (R1) (18.2% vs 20.5%,
P = 0.99) between the two groups.ConclusionsAn aberrant hepatic artery does not increase morbidity or R1 resection in patients undergoing PD.
Evaluating novel silica hydride‐based stationary phases for the analysis of phytocannabinoids and other psychoactive drugs
Authors: Watanabe Seiichiro , Santos Theresa Q. , Matyska‐Pesek Maria T. , Pesek Joseph J. 
Published: March 2019

AbstractThree silica hydride based novel chromatographic phases chemically‐bonded with allyloxy‐DL‐alpha‐tocopherol, allylpentafluorophenyl, and 1‐eicosene moieties were evaluated as separation media for selected phytocannabinoids and other substances of abuse. In order to assess column selectivity, a series of reference standards was analyzed and detected by using liquid chromatography with mass spectrometry. Further, quantitative detections of cannabidiol and tetrahydrocannabinol were attempted for the extracts of cannabis plants and cannabidiol gummy formulation. For potential bioanalytical applications, the columns were evaluated for substance screening in a human urine matrix. In summary, the newly developed columns are functional and effective for the analysis of phytocannabinoids and various psychoactive drugs with or without the presence of biological matrices.
Correlation between Hypervascularization of the First Annular Pulley on Color Doppler Imaging of Trigger Finger and Patients’ Backgrounds
Authors: Sato Junko , Ishii Yoshinori , Noguchi Hideo 
Published: March 2019

ObjectivesThe aim of this study was to investigate the correlation between hypervascularization of the first annular (A1) pulley on color Doppler imaging of trigger finger and patients’ backgrounds.MethodsA total of 148 trigger digits from 144 patients were studied with ultrasound at the time of initial diagnosis. We observed the A1 pulley at the level of the metacarpophalangeal joint in a transverse image and noted the presence or absence of a signal in the A1 pulley on color Doppler imaging. Patients’ ages, sexes, clinical grades, symptom durations, prevalence of interphalangeal joint contracture, and visual analog scale pain scores were compared between the groups with positive and negative Doppler findings.ResultsThe 144 patients included 45 men and 99 women. Sixty‐one of 148 digits (41%) showed positive Doppler findings in the A1 pulley. Patients’ ages and visual analog scale scores in the Doppler‐positive group were slightly greater than those in the Doppler‐negative group (P = .03; P < .01, respectively). The digit with positive Doppler findings tended to be categorized into a severer grade and into the group with a shorter symptom duration (P < .01 for both).ConclusionsHypervascularization of the A1 pulley tended to appear in an earlier period after the patients had become aware of symptoms, as frequently as their symptoms became severe, in conjunction with higher pain scores. Doppler imaging of the A1 pulley might help in better understanding patients’ conditions.
Demonstrating the benefits of a multidisciplinary aerodigestive program
Authors: Ruiz Amanda G. , Bhatt Jay M. , DeBoer Emily M. , Friedlander Joel , Janosy Norah , Peterson Melissa Brooks , Wine Todd , Deterding Robin , Prager Jeremy D. 
Published: March 2019

Objectives/HypothesisThe Aerodigestive Program (the Aero Program) at Children's Hospital Colorado is a multidisciplinary program focused on airway, digestive, and lung disorders in complex children, involving collaboration between gastroenterology, pulmonology, anesthesiology, and otolaryngology in clinic and operating room. These programs have proliferated as institutions focus on providing greater care coordination and family satisfaction. However, few cost, charge, and satisfaction data exist to support these resource‐intensive programs. The goal of this study was to investigate the value of combined triple endoscopy delivered by the Aero Program through analysis of institutional charges, direct costs, operating room efficiency metrics, and parent satisfaction.Study DesignProgram evaluation.MethodsFinance, satisfaction, efficiency, and quality‐of‐care metrics were evaluated within and outside of the Aero Program through retrospective queries of electronic health records, administrative databases, and parent surveys at our institution.ResultsMean anesthesia time in the Aero Program was 54 minutes (49–60; 95% confidence interval), which was significantly less (P < .0001) than the estimated 89 minutes of having the three procedures done separately. Average charges and average direct costs for triple endoscopy were 38.8% and 41.9% less than the sum of the averages for separate procedures, respectively. Parent satisfaction was high for the Aero Program care.ConclusionsAs organizations move toward greater coordination of care for complex patients, multidisciplinary programs must demonstrate their value by delivering cost‐effective care. Aerodigestive programs have the potential to provide satisfying care that is less costly to the organization, insurer, and family. These programs represent a step in the evolution toward higher value care and value‐based payment methodology.Level of Evidence4 Laryngoscope, 130:521–525, 2020