bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with physical activity engagement among adults with rheumatoid arthritis: A cross‐sectional study
Authors: Tan Xiang Li , Pugh Gemma , Humby Frances , Morrissey Dylan 
Published: February 2019

AbstractObjectivesPhysical activity (PA) has a number of benefits for rheumatoid arthritis (RA) patients. However, these patients are more physically inactive than the general population. The primary aim of this study was to investigate factors associated with PA engagement among RA patients. The secondary aim was to identify their preference for PA support.MethodsThere were 96 participants, 76 of whom were female, with a mean age of 56.9 years (range = 34–72 years) and a median RA disease duration of 5 years (interquartile range = 2–12). All patients completed questionnaires assessing demographic status, health status (including cardiovascular disease [CVD] risk and RA disease profile), PA levels and preferences, alongside the perceived benefits of—and barriers to—PA. Hierarchical regressions were carried out to assess the relationship between reported PA levels and both engagement determinants and disease features.ResultsForty‐five per cent (n = 44) had low levels (<600 metabolic equivalent‐min/week) of PA. Low level of PA was significantly associated with: CVD risk profile (ηp2 = 0.118, p < 0.002); functional disability (ηp2 = 0.206, p < 0.032); pain (ηp2 = 0.154, p < 0.028); general personal (ηp2 = 0.190, p < 0.001) and arthritis‐specific personal (ηp2 = 0.170, p < 0.001) barriers to PA; age (ηp2 = 0.076, p < 0.026); and sedentary behaviour (ηp2 = 0.275, p < 0.001). Participants displayed a preference for unsupervised (n = 37, 38.5%), low‐intensity (n = 45, 46.9%), indoor home (n = 50, 52.1%) exercises, with no preferences for the diversity of the exercise prescribed (n = 39, 40.6%) or for who provided the exercise counselling (n = 34, 35.4%).ConclusionsThese results suggest that CVD profile, disability, pain, and general and arthritis‐specific personal barriers are associated with PA levels among RA patients. Intervention development should address these factors to facilitate an increase in PA uptake.
Association Between Fat‐Free Mass and Pulmonary Function in Patients With Cystic Fibrosis: A Narrative Review
Authors: Gomes Allison , Hutcheon Deborah , Ziegler Jane 
Published: February 2019

AbstractThe association between body mass index (BMI) and pulmonary function in patients with cystic fibrosis (CF) is well established, yet BMI as the sole indicator of nutrition status fails to assess body composition, specifically fat‐free mass (FFM). Reduced FFM is a characteristic of undernutrition and is associated with decreased pulmonary function. A critical review of the literature was undertaken to explore available evidence on the use of FFM derived from dual‐energy X‐ray absorptiometry (DXA), compared with BMI, to assess pulmonary function and thereby nutrition status in patients with CF. Four cross‐sectional studies that met predefined inclusion and exclusion criteria were selected for review. Based on the evidence reviewed, reduced FFM was associated with reduced pulmonary function in both children and adults with CF. FFM was reduced among patients who may not otherwise be identified as at nutrition risk based on BMI alone. FFM, as compared with BMI, appears to be a better indicator of pulmonary function and nutrition status in patients with CF. Although future research is needed to identify and determine FFM measurements that are associated with improved pulmonary function and nutrition status in patients with CF, these findings highlight the potential value and clinical utility of using FFM measurements derived from DXA among patients with CF. Together, FFM and BMI may provide a more comprehensive picture of nutrition status during the nutrition assessment of the patient with CF.
Increasing Enteral Protein Intake in Critically Ill Trauma and Surgical Patients
Authors: O'Keefe Grant E. , Shelton Marilyn , Qiu Qian , Araujo‐Lino Jose Cruz 
Published: February 2019

AbstractBackgroundPublished guidelines recommend providing at least 2 g/kg/d of protein for critically ill surgical patients. It may be difficult to achieve this level of intake using standard enteral formulas, thus necessitating protein or amino acid supplementation. Herein, we report our approach to enteral protein supplementation and its relationship with urinary nitrogen excretion and serum transthyretin concentrations.MethodsThis was a retrospective cohort study in which we reviewed critically ill trauma and surgical patients treated with supplemental enteral protein according to a protocol aiming to deliver a total of 2 g/kg/d of protein. We collected detailed nutrition data over a 2‐week period after admission and obtained additional data through discharge to determine caloric and protein intake as well as complications. We also compared urine nitrogen excretion and transthyretin concentrations between these patients and a control group who did not receive supplemental protein.ResultsFifty‐three subjects received early protein supplementation. Formula and protein supplement each provided ≈1.2 g/kg/d of protein by intensive care unit day 4. This resulted in a median total protein intake of 2.2 g/kg/d through day 14. One patient developed acute kidney injury, and 1 patient had 3 episodes of vomiting. By the third week, serum transthyretin concentrations increased to a median of 21 mg/dL compared with 13 mg/dL in subjects not receiving early supplementation.ConclusionIt is safe to deliver supplemental protein enterally to critically ill surgical and trauma patients and reach 2 g/kg/d of protein intake during the first week of illness.
Classification of the acute emetogenicity of chemotherapy in pediatric patients: A clinical practice guideline
Authors: Paw Cho Sing Edric , Robinson Paula D. , Flank Jacqueline , Holdsworth Mark , Thackray Jennifer , Freedman Jason , Gibson Paul , Orsey Andrea D. , Patel Priya , Phillips Robert , Portwine Carol , Raybin Jennifer L. , Cabral Sandra , Sung Lillian , Dupuis L. Lee 
Published: February 2019

AbstractThis clinical practice guideline (CPG) provides clinicians with recommendations regarding chemotherapy emetogenicity classification in pediatric oncology patients. This information is critically important for the appropriate selection of antiemetic prophylaxis. Recommendations are based on a systematic review limited to pediatric patients and a framework for classification when antiemetic prophylaxis is provided. Findings of 87 publications informed the emetogenicity classification of 49 single‐agent and 13 combination‐agent regimens. Information required for the classification of many chemotherapies commonly administered to pediatric patients is lacking. In the absence of pediatric data, consultation of methodologically sound CPGs aimed at adult oncology patients may be appropriate.
Nutritional status at diagnosis of cancer in children and adolescents in Guatemala and its relationship to socioeconomic disadvantage: A retrospective cohort study
Authors: Villanueva Gabriela , Blanco Jessica , Rivas Silvia , Molina Ana Lucia , Lopez Nidia , Fuentes Ana Lucia , Muller Leslie , Caceres Annie , Antillon Federico , Ladas Elena , Barr Ronald D. 
Published: February 2019

AbstractBackgroundAt least 80% of children with cancer live in low‐ and middle‐income countries where the prevalence of malnutrition and socioeconomic disadvantage is high. We examined the relationship between nutritional status (NS), assessed by arm anthropometry, and socioeconomic status (SES) in children diagnosed with cancer at Unidad Nacional de Oncologia Pediatrica (UNOP) in Guatemala over a three‐year period.MethodPatients aged 0 to 18 years of age diagnosed between January 2015 and December 2017 were included. NS was evaluated by mid‐upper arm circumference, triceps skin fold thickness, and serum albumin level, and subjects were classified as adequately nourished, moderately depleted, and severely depleted nutritionally. SES was measured by a 15‐item instrument developed at UNOP.ResultsOf 1365 patients diagnosed in the study period, 1060 (78%) fulfilled the eligibility criteria. Only 6% of patients were classified as medium to high, the remainder as medium–low to extremely low SES. Almost 47% were severely depleted at diagnosis, 19% moderately depleted, and 34% adequately nourished. SES was shown to be a determinant of NS; with progressively lower SES, the probability of a decline in NS increased by a factor of 1.04 points (P < 0.0001). Leukemia and lymphoma were also important predictors of nutritional depletion with odds ratios of 6.08 (95% CI, 1.74–28.28; P = 0.008) for leukemias and 4.83 (95% CI, 1.33–23.03; P = 0.03) for lymphomas.ConclusionBoth low SES and a diagnosis of leukemia or lymphoma are strong predictors of poor NS at diagnosis in children with cancer in Guatemala.
Improving the performance of inverted organic solar cells by embedding silica‐coated silver nanoparticles deposited by electron‐beam evaporation
Authors: N'Konou Kekeli , Chalh Malika , Lucas Bruno , Vedraine Sylvain , Torchio Philippe 
Published: February 2019

AbstractEmbedding metallic nanoparticles (MNPs) in organic solar cells (OSCs) is proposed as one of the promising strategies to enhance their photovoltaic performance owing to localized surface plasmon resonance, light scattering effects or a synergy of both effects derived from the MNPs. However, it has been demonstrated that MNPs wrapped by a thin dielectric silica shell can lead to better photovoltaic yield than bare MNPs due to the presence of the dielectric shell which avoids direct contact between the active layer and the MNPs, reducing the charge recombination and the exciton quenching loss at the metal surface. In this study, we report an alternative solution using an ultrathin dielectric layer coating silver nanoparticles (Ag NPs) for improving the performance of plasmonic inverted OSCs instead of the use of metal–dielectric core–shell NPs. A silica (SiO2) layer 5 nm thick coating evaporated Ag NPs with an average size of 60 nm is deposited on top of the zinc oxide (ZnO) layer used as the electron transport layer, leading to a significant improvement in the short‐circuit current density (Jsc) and the power conversion efficiency (PCE) of the inverted OSCs. The electron‐beam evaporation method is employed for controlled deposition of Ag NPs and SiO2 on the ZnO layer. The plasmonic devices resulted in an 18% and 14.1% enhancement of the Jsc and PCE, respectively, compared to reference devices. This increase of the photoelectric parameters in plasmonic devices is attributed not only to the plasmonic effects originating from the Ag NPs but also to the ultrathin silica layer which can contribute to facilitating charge extraction. © 2019 Society of Chemical Industry
Understanding the Level of Concussion Knowledge in High School Sports in New Jersey
Authors: Lin Emerald , Ward Irene , Lequerica Anthony , Jasey Neil , Chiaravalloti Nancy 
Published: February 2019

BackgroundCoaches, athletic trainers (ATCs), and parents/guardians (parents) are important contributors to the proper identification and management of concussions in student‐athletes. However, there are limited studies on the identification of concussion knowledge gaps that will help inform educational efforts and improve concussion outcomes in these groups.ObjectiveTo identify gaps and factors influencing concussion knowledge for high school athletics.DesignSurvey.SettingPublic, private, and recreational leagues in New Jersey.Participants41 coaches, 34 ATCs, and 65 parents of high school student‐athletes.MethodsA 17‐item online survey examining concussion knowledge was distributed to coaches, ATCs, and parents. Analyses included ANOVA for between‐group comparisons of continuous variables and Pearson's correlations for categorical data.Main Outcome MeasurementsDemographics, concussion knowledge, application of knowledge, access to educational materials, and confidence in the ability to identify concussions.ResultsSignificant between‐group differences were found for overall knowledge (F[2137] = 11.0, P < .001), factual knowledge (F[2137] = 8.7, P < .001), and application of knowledge (F[2137] = 3.5, P = .03), with parents scoring lower. Coaches, ATCs, and parents had gaps in factual knowledge of baseline testing scores and identification regarding symptom severity. More coaches (73.2%) and ATCs (97.1%) felt confident in concussion knowledge compared with parents (31.3%; P < .001). All groups thought mandatory education, new law, and guidelines were positive in promoting better care of student‐athletes.ConclusionsKnowledge gaps were identified in all groups. Educational programs for these groups should consider including targeted techniques, including vignettes, to illustrate application of concussion knowledge.Level of EvidenceIII.
Team‐Based Medicine: Incorporating a Clinical Pharmacist into Pain and Opioid Practice Management
Authors: Boren Lacey L. , Locke Amanda M. , Friedman Andrew S. , Blackmore Craig C. , Woolf Roger 
Published: February 2019

BackgroundThe Centers for Disease Control and Prevention (CDC) reports that death from opioids has increased by more than five times since 1999. In response, federal and state organizations have released guidelines recommending best practice standards to combat the opioid epidemic.ObjectiveTo evaluate the impact of a clinical pharmacist in a team‐based care model on the adherence to best practice standards and access to care for management of patients prescribed chronic opioid therapy (COT).DesignRetrospective chart review study.SettingAn outpatient physical medicine and rehabilitation clinic in a tertiary hospital.PatientsThree hundred eighty‐three patients presenting to the clinic between January 2012 and August 2016 with chronic, noncancer pain.MethodsComparison of adherence to best practice standards—including changes in morphine equivalent dose (MED), compliance with urine drug screenings, documentation of medication agreements, initiation of nonopioid medications, and the impact of comorbidities—was analyzed before and after a clinical pharmacist was added to the team. Data were gathered from the electronic medical record and the Prescription Monitoring Program. A control group of patients who did not see the pharmacist and were managed only by the physician section head was also compared to the group of patients managed by a clinical pharmacist.Outcome MeasurementsThe primary outcome measurement evaluates the change in MED values over time. Secondary outcome measurements are to review compliance with annual urine drug screening, documentation of the medication agreement, initiation of nonopioid medications by the pharmacist, and assessment of the access to care for patients with chronic opioid therapy needs.ResultsA clinically significant reduction in MED with an average decrease of 207 mg was seen after five or more visits with the pharmacist. The pharmacist initiated nonopioid medications at 209 unique patient visits (19.5%). The pharmacist completed 1197 visits during the study time frame, increasing physician access by at least two additional visits per patient per year. Completion of urine drug screens and medication agreement reviews improved over time (P < .001). There was an increase in MED for patients who did not complete this monitoring, whereas the MED remained stable in patients who did complete the monitoring.ConclusionsThe addition of a clinical pharmacist to an interdisciplinary team managing COT patients resulted in a MED reduction after five or more visits with the pharmacist, improved adherence to best practice standards, optimization of opioid and nonopioid medication therapy, and increased patient access. Developing a role for advanced practitioners, such as clinical pharmacist providers, working with patients on COT can result in significant improvements in patient access to care, adherence to best practice standards, and patient safety.Level of EvidenceIII.
Motor Adaptation to Weight Shifting Assistance Transfers to Overground Walking in People with Spinal Cord Injury
Authors: Lin Jui‐Te , Hsu Chao‐Jung , Dee Weena , Chen David , Rymer W. Zev , Wu Ming 
Published: February 2019

BackgroundLocomotor training has been used to improve walking function in people with incomplete spinal cord injury (iSCI), but functional gains are relatively small for some patients, which may be due to the lack of weight shifting training.ObjectiveTo determine whether applying a pelvis assistance force in the coronal plane during walking would improve weight shifting and stepping in people with iSCI.DesignRepeated measures study.SettingRehabilitation hospital.ParticipantsSeventeen people with iSCI.InterventionsA controlled assistance force was bilaterally applied to the pelvis in the medial‐lateral direction to facilitate weight shifting, which gradually increased during the course of treadmill walking.Main Outcome MeasuresWeight shifting, step length, margin of stability, and muscle activities of the weaker leg were used to quantify gait performance. The spatial‐temporal gait parameters during overground walking were collected pre, post, and 10 minutes after treadmill training.ResultsDuring treadmill walking, participants significantly improved weight shifting (ie, center of mass [CoM] lateral distance reduced from 0.16 ± 0.06 m to 0.12 ± 0.07 m, P = .012), and increased step length (from 0.35 ± 0.08 m to 0.37 ± 0.09 m, P = .037) on the stronger side when the force was applied, which were partially retained (ie, CoM distance was 0.14 ± 0.06, P = .019, and step length was 0.37 ± 0.09 m, P = .005) during the late postadaptation period when the force was removed. In addition, weight shifting and step length on the weaker side during overground walking also improved (support base reduced from 0.13 ± 0.06 m to 0.12 ± 0.06 m, P = .042, and step length increased from 0.48 ± 0.12 m to 0.51 ± 0.09 m, P = .045) after treadmill training.ConclusionsApplying pelvis assistance during treadmill walking may facilitate weight shifting and improve step length in people with SCI, which may partially transfer to overground walking.Level of EvidenceIII.
Sarcopenia among Adults with Cerebral Palsy in South Korea
Authors: Jeon Inpyo , Bang Moon Suk , Lim Jae Young , Shin Hyung‐Ik , Leigh Ja‐Ho , Kim KeeWon , Kwon Bum Sun , Jang Soong‐Nang , Jung Se Hee 
Published: February 2019

BackgroundMost adults with cerebral palsy encounter newly developing physical health problems and premature functional decline with aging. These physical and functional losses along with the characteristic symptoms of cerebral palsy may heighten the risk of sarcopenia.ObjectiveTo determine the prevalence of sarcopenia among a selected group of adults with cerebral palsy and to identify the factors associated with their sarcopenia among them.DesignCross‐sectional study.SettingUniversity hospitals and communities for persons with disabilities.ParticipantsA total of 80 adults with cerebral palsy (46 men and 34 women with mean age of 42.8 ± 8.86 years) were included.MethodMuscle mass, strength, and physical performance were measured to diagnose sarcopenia. Participants also completed a structured questionnaire for physical, psychological, or socioeconomic attributes and health‐related quality of life.Main Outcome MeasuresPrevalence of sarcopenia in adults with cerebral palsy.ResultsThe prevalence of sarcopenia was 47.9%. Sarcopenia was significantly associated with sex, the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), body mass index (BMI), and trunk fat. Male, higher GMFCS and lower BMI were significant risk factors of sarcopenia. Sarcopenic adults with cerebral palsy showed significantly lower health‐related quality of life.ConclusionThe prevalence of sarcopenia in adults with cerebral palsy was higher than that of general population despite the young age of the selected group. Modifiable risk factor was a low BMI.Level of EvidenceIII
Experimental and theoretical studies of (4 + 1) annulations between α‐oxoketenes and stable phosphorous, nitrogen, or sulfur ylides
Authors: Pierrot David , Rajzmann Michel , Carissan Yannick , Rodriguez Jean , Bonne Damien , Coquerel Yoann 
Published: February 2019

Abstractα‐Oxoketenes generated in situ by a microwave‐assisted Wolff rearrangement at 170°C were found to react with stabilized sulfur ylides in (4 + 1) annulation processes to afford functionalized 3‐hydroxyfurans. Theoretical mechanistic investigations revealed that the reaction proceeds in two steps via a short‐lived betaine intermediate, a general feature of the reactions of α‐oxoketenes with stable phosphorous, nitrogen, and sulfur ylides.
The Effect of HMX Impurity and Irganox Antioxidant on Thermal Decomposition Kinetics of RDX by TG/DSC Non‐Isothermal Method
Authors: Sinapour Hamid , Damiri Sajjad , Ravanbod Mohsen , Pouretedal Hamid R. 
Published: February 2019

AbstractThe non‐isothermal TG/DTG/DSC technique has been used to study the thermal decomposition of RDX as pure and impure (contain 5 wt. % HMX) in the absence and presence of 5 wt. % irganox 1010 antioxidant under nitrogen atmosphere at different heating rates (4, 6, 8, and 10 °C min−1). The DSC curves show an exothermic peak for decomposition of RDX exactly after its melting point. The activation energy (Ea) for thermal decomposition of pure and impure RDX in the absence and presence of irganox was calculated using non‐isothermal isoconversional methods of KAS, OFW, and Friedman for different conversion fraction (α) values in the range of 0.1–0.9. The pre‐exponential factor (A) and the kinetic model have been determined by means of the compensation effect and the selected model is confirmed by the nonlinear fitting method. The activation energies for thermal decomposition of pure RDX in the absence and presence of irganox are 240.5 to 246.2 and 330.0 to 350.6 kJ mol−1 with the reaction model of R3 and D2, respectively, whereas; the Ea values for decomposition of impure RDX in the absence and presence of antioxidant are 172.1 to 173.0 and 195.3 to 214.2 kJ mol−1, respectively, with the reaction model of R2 for both of them.
Chemoprotective effects of Ulva lactuca (green seaweed) aqueous‐ethanolic extract against subchronic exposure to benzo(a)pyrene by CYP1A1 inhibition in mice
Authors: Delgado‐Roche Livan , Rodeiro Idania , Riera Mario , Herrera José Alfredo , Venturi Ivonilce , Hernández Yasnay , Fernández Gisselle , Pérez Carlos Luis , Rodriguez Juan Carlos , Fernández Miguel David , Hernández‐Balmaseda Ivones , Fernández Julio Raul , Mesta Fernando , Paz Miriam Teresa 
Published: February 2019

The protective effect of the supplementation with an aqueous‐ethanolic extract obtained from Ulva lactuca (Delile) green seaweed on benzo[a] pyrene‐induced damage in mice was evaluated. Animals were treated with oral doses of U. lactuca extract (100 and 400 mg/kg) for 9 weeks. They were exposed to 50 mg/kg of oral doses of benzo(a)pyrene starting from the second week and up to the fifth week. Groups treated with benzo(a)pyrene only (second to fifth weeks), sunflower oil (vehicle, 9 weeks), or U. lactuca extract (100 and 400 mg/kg, 9 weeks) were also included in the study. The treatment with 400 mg/kg of the extract ameliorated the oxidative damage, decreased IL‐1β and TNF‐α levels, and favorably regulated the antioxidant defenses compared with benzo(a)pyrene‐exposed group. The benzo(a)pyrene‐induced DNA damage was also reduced, as it was evidenced by the lower micronucleus formation in U. lactuca extract‐supplemented animals. The extract protected the hepatic tissue, and it reduced the liver activity/expression of CYP1A1. These results altogether suggested a chemoprotective effect of U. lactuca extract against benzo(a)pyrene‐induced‐toxicity in mice, probably associated with an inhibitory effect of carcinogen bioactivation.