bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling the Effect of Inulin, pH and Storage Time on the Viability of Selected Lactobacillus in a Probiotic Fruity Yogurt Drink Using the Monte Carlo Simulation
Authors: Nikmaram Parang , Mousavi Seyed Mohamad , Kiani Hossein , Emamdjomeh Zahra , Razavi Seyed Hadi , Mousavi Zeinab 
Published: April 2016

AbstractThe effects of pH (5.5, 5.75, 6 and 6.75) and inulin concentration (0, 0.5, 1 and 2%) on the survival of Lactobacillus casei 431 and Lactobacillus acidophilus LA‐5 in pomegranate yogurt drink during 21 days refrigerator storage at 4C were studied. A polynomial multiple regression equation was used in Monte Carlo simulation to predict the probiotic viability. The model fitted well with experimental data (for L. casei R2 = 0.90 and L. acidophilus R2 = 0.96). Also, sensitivity analysis was applied to identify most substantial factors affected the viability. Through the probability distribution, it was demonstrated that L. casei accommodated to manipulation of the environmental conditions (pH and % inulin) while L. acidophilus failed at the end of shelf life and fell down below the critical number of 106 cfu/mL. The Monte Carlo simulation can be a useful device to estimate the amount of viable probiotic bacteria exist in final product.Practical ApplicationsIn this study, a functional beverage was produced because the viable probiotic cells are known to be beneficial for human body when sufficient amounts (at least 106 cfu/mL) of probiotic bacteria are carried through dairy products. Monte Carlo simulation can be a robust predictive model in practical industrial applications and in research to make reliable statements about the survival/inactivation of probiotic bacteria when the formulation is changed. Also, this tool makes the industries able to determine the best time to consume a probiotic product to uptake adequate amount of useful microorganisms by the end consumer.
Quality in paediatric emergency medicine: Measurement and reporting
Authors: Borland Meredith L , Shepherd Mike 
Published: April 2016

AbstractThere is a clear demand for quality in the delivery of health care around the world; paediatric emergency medicine is no exception to this movement. It has been identified that gaps exist in the quality of acute care provided to children. Regulatory bodies in Australia and New Zealand are moving to mandate the implementation of quality targets and measures. Within the paediatric emergency department (ED), there is a lack of research into paediatric specific indicators. The existing literature regarding paediatric acute care quality measures has been recently summarised, and expert consensus has now been reported. It is clear that there is much work to be performed to generalise this work to ED. We review suggestions from the current literature relating to feasible indicators within the paediatric acute care setting. We propose options to develop a quality ‘scorecard’ that could be used to assist Australian and New Zealand EDs with quality measurement and benchmarking for their paediatric patients.
Scoring systems in paediatric emergency care: Panacea or paper exercise?
Authors: Roland Damian , McCaffery Kevin , Davies Ffion 
Published: April 2016

AbstractScoring systems to recognise the most ill patients, or those at risk of deterioration, are increasingly utilised in hospitals that look after paediatric inpatients. There have been efforts to implement these systems in emergency and urgent care settings, but they have yet unproven value. This is because the child or young person presenting acutely is a different cohort than the ‘treated’ ward‐based group. The majority of children presenting to emergency and urgent care settings are discharged home, and so, scoring systems need to recognise the most unwell but also assist in safe and appropriate discharge as well as highlighting those patients in need of more senior review. This article explores this conundrum, suggesting how cognitive factors have a role to play, and how scoring systems can have wider effects than just individual patient care.
Promotion and prelacteal feeding of breastmilk substitutes among mothers in Kathmandu Valley, Nepal
Authors: Pries Alissa M. , Huffman Sandra L. , Adhikary Indu , Upreti Senendra Raj , Dhungel Shrid , Champeny Mary , Zehner Elizabeth 
Published: April 2016

AbstractIn 1992, Nepal passed the Mother's Milk Substitutes (Control of Sale and Distribution) Act in order to regulate the sale, distribution and promotion of substitutes for breastmilk within Nepal, in an effort to protect and promote breastfeeding. Helen Keller International, in collaboration with Nepal's Ministry of Health and Population's Child Health Division, implemented a study to assess mothers' exposure to promotions for and utilization of breastmilk substitutes in Kathmandu Valley, Nepal. A health facility‐based, cross‐sectional survey was conducted among 304 mothers being discharged after delivery. Prelacteal feeding of breastmilk substitutes is prevalent (55.9% of mothers, n = 170). Reported recommendations during antenatal checks and after delivery from health professionals to use breastmilk substitutes were prevalent, occurring among 47.4% (n = 144) of mothers; rates of these recommendations were significantly higher for mothers that delivered in private health facilities, as compared with public (67.7% vs. 38.0%, P < 0.001). Mothers that received a recommendation to use a breastmilk substitute from a health worker were 16.7 times more likely to provide a prelacteal feed of a breastmilk substitute, as compared with mothers that did not receive a recommendation (P < 0.001). Few mothers reported observation of commercial advertisements for breastmilk substitutes inside a health facility (reported by 3.6% of mothers). No mothers reported receiving a sample of a breastmilk substitute, bottle or teat from a health professional. More information is needed to determine why there is such a high rate of health worker recommendations for breastmilk substitute use in the first few days after delivery.Key messages

While utilization of breastmilk substitutes is low among mothers of young children in Nepal, prelacteal feeding of breastmilk substitutes is highly prevalent in Kathmandu Valley.
Reported recommendations from health professionals to use breastmilk substitutes are common (over 40%) and are associated with prelacteal feeding among Nepal mothers included in this study.
Provision of lactation management training to health workers and monitoring their practices regularly could strengthen breastfeeding counselling, aid in reducing high rates of prelacteal feeding and contribute to improved infant feeding practices.
High use of commercial food products among infants and young children and promotions for these products in Cambodia
Authors: Pries Alissa M. , Huffman Sandra L. , Mengkheang Khin , Kroeun Hou , Champeny Mary , Roberts Margarette , Zehner Elizabeth 
Published: April 2016

AbstractDespite national improvements in child survival, 40% of Cambodian children less than 5 years of age are stunted. Commercially produced complementary foods could be nutritionally beneficial for young children in Cambodia if fortified and of optimal nutrient composition. However, other nutrient‐poor commercially produced snack foods may be detrimental to young child feeding by displacing consumption of other nutritious foods. This study assessed consumption of commercial food products among infants and young children and their mothers' exposure to promotions for these products. A cross‐sectional survey was conducted among 294 mothers of children less than 24 months of age living in Phnom Penh. Of children 6‐23 months of age, 55.0% consumed a commercially produced snack food product on the prior day, and 80.6% had consumed one in the prior week. Only 12 (5.4%) children 6‐23 months of age had consumed a commercially produced complementary food. Almost all mothers (96.9%) had observed a promotion for a commercially produced snack food product, and 29.3% reported observation of a promotion for a commercial complementary food. Only one‐third (32.9%) of children 6‐23 months of age achieved a minimum acceptable diet. Findings indicate that there is a need to improve infant and young child feeding practices among children less than 24 months of age living in Phnom Penh. Nutritious options should be promoted, and consumption of unhealthy commercially produced snack food products should be discouraged.
Point‐of‐sale promotion of breastmilk substitutes and commercially produced complementary foods in Cambodia, Nepal, Senegal and Tanzania
Authors: Champeny Mary , Pereira Catherine , Sweet Lara , Khin Mengkheang , Ndiaye Coly Aminata , Sy Gueye Ndeye Yaga , Adhikary Indu , Dhungel Shrid , Makafu Cecilia , Zehner Elizabeth , Huffman Sandra L. 
Published: April 2016

AbstractIn order to assess the prevalence of point‐of‐sale promotions of infant and young child feeding products in Phnom Penh, Cambodia; Kathmandu Valley, Nepal; Dakar Department, Senegal; and Dar es Salaam, Tanzania, approximately 30 retail stores per site, 121 in total, were visited. Promotional activity for breastmilk substitutes (BMS) and commercially produced complementary foods in each site were recorded. Point‐of‐sale promotion of BMS occurred in approximately one‐third of sampled stores in Phnom Penh and Dakar Department but in 3.2% and 6.7% of stores in Kathmandu Valley and Dar es Salaam, respectively. Promotion of commercially produced complementary foods was highly prevalent in Dakar Department with half of stores having at least one promotion, while promotions for these products occurred in 10% or less of stores in the other three sites. While promotion of BMS in stores is legal in Senegal, it is prohibited in Cambodia without prior permission of the Ministry of Health/Ministry of Information and prohibited in both Nepal and Tanzania. Strengthening legislation in Senegal and enforcing regulations in Cambodia could help to prevent such promotion that can negatively affect breastfeeding practices.Key messages
Even in countries such as Cambodia, Nepal and Tanzania where point‐of‐sale promotion is restricted, promotions of BMS were observed (in nearly one‐third of stores in Phnom Penh and less than 10% in Dar es Salaam and Kathmandu).
Limited promotion of commercially produced complementary foods was evident (less than 10% of stores had a promotion for such foods), except in Dakar Department, where promotions were found in half of stores.
Efforts are needed to strengthen monitoring, regulation and enforcement of restrictions on the promotion of BMS.
Manufacturers and distributors should take responsibility for compliance with national regulations and global policies pertaining to the promotion of breastmilk substitutes.
Infant and young child feeding practices among children under 2 years of age and maternal exposure to infant and young child feeding messages and promotions in Dar es Salaam, Tanzania
Authors: Vitta Bineti S. , Benjamin Margaret , Pries Alissa M. , Champeny Mary , Zehner Elizabeth , Huffman Sandra L. 
Published: April 2016

AbstractThere are limited data describing infant and young child feeding practices (IYCF) in urban Tanzania. This study assessed the types of foods consumed by children under 2 years of age and maternal exposure to promotions of these foods in Dar es Salaam, Tanzania. A cross‐sectional survey was conducted among 305 mothers of children less than 24 months of age who attended child health services in October and November, 2014. Among infants less than 6 months of age, rates of exclusive breastfeeding were low (40.8%) and a high proportion (38.2%) received semi‐solid foods. Continued breastfeeding among 20–23‐month‐olds was only 33.3%. Consumption of breastmilk substitutes was not prevalent, and only 3.9% of infants less than 6 months of age and 4.8% of 6–23 month‐olds were fed formula. Among 6–23‐month‐olds, only 38.4% consumed a minimum acceptable diet (using a modified definition). The homemade complementary foods consumed by the majority of 6‐23‐month‐olds (85.2%) were cereal‐dominated and infrequently contained micronutrient‐rich ingredients. Only 3.1% of 6–23‐month‐olds consumed commercially produced infant cereal on the day preceding the interview. In contrast, commercially produced snack foods were consumed by 23.1% of 6–23‐month‐olds. Maternal exposure to commercial promotions of breastmilk substitutes and commercially produced complementary foods was low (10.5% and 1.0%, respectively), while exposure to promotions of commercially produced snack foods was high (45.9%). Strategies are needed to improve IYCF practices, particularly with regard to exclusive and continued breastfeeding, increased dietary diversity and consumption of micronutrient‐rich foods, and avoidance of feeding commercially produced snack foods.
Population genomic scans suggest novel genes underlie convergent flowering time evolution in the introduced range of Arabidopsis thaliana
Authors: Gould Billie A. , Stinchcombe John R. 
Published: April 2016

AbstractA long‐standing question in evolutionary biology is whether the evolution of convergent phenotypes results from selection on the same heritable genetic components. Using whole‐genome sequencing and genome scans, we tested whether the evolution of parallel longitudinal flowering time clines in the native and introduced ranges of Arabidopsis thaliana has a similar genetic basis. We found that common variants of large effect on flowering time in the native range do not appear to have been under recent strong selection in the introduced range. We identified a set of 38 new candidate genes that are putatively linked to the evolution of flowering time. A high degree of conditional neutrality of flowering time variants between the native and introduced range may preclude parallel evolution at the level of genes. Overall, neither gene pleiotropy nor available standing genetic variation appears to have restricted the evolution of flowering time to high‐frequency variants from the native range or to known flowering time pathway genes.
Pharmacological management of IPF
Authors: Borie Raphael , Justet Aurelien , Beltramo Guillaume , Manali Effrosyni D. , Pradère Pauline , Spagnolo Paolo , Crestani Bruno 
Published: April 2016

AbstractIdiopathic pulmonary fibrosis (IPF) is a deadly disease with a median survival of approximately three years in historical cohorts. Despite increased knowledge of disease pathophysiology and selection of more targeted therapy, main clinical trials yielded negative results. However, two agents, pirfenidone and nintedanib, were recently shown to be effective in IPF and received marketing authorization worldwide. Both drugs significantly reduce functional decline and disease progression with an acceptable safety profile. Yet, none of these drugs actually improves or even stabilizes the disease or the symptoms perceived by the patient. Several other treatments and combinations are currently tested, and many more are ready for clinical trials. Their completion is critical for achieving the ultimate goal of curing patients with IPF.
We Restrict CRRT to Only the Most Hemodynamically Unstable Patients
Authors: Kashani Kianoush , Mehta Ravindra L. 
Published: April 2016

AbstractFrom the initial version of an extended renal replacement therapy, the initiative to provide safer, more efficient means for detoxification and volume removal in comparison with intermittent renal replacement therapies (IRRT) has been evaluated. As a result, the Kidney Disease Improving Global Outcomes guidelines for acute kidney injury recommend the preferential use of continuous renal replacement therapy (CRRT) in patients who are hemodynamically unstable or who suffer from intracranial hypertension. The choice of dialysis modality is also influenced by other factors including clinical expertise, and the availability of each treatment option in individual medical centers. In the scientific community, there is an ongoing debate regarding the choice of dialysis modality. On one side, the inability of recent studies to demonstrate any mortality or renal recovery benefit for CRRT, the need for patient immobilization, and prohibitive additional costs impede widespread adoption of the method.On the other side, the physiological advantages of CRRT in detoxification and volume removal and the identified flaws related to the comparative literature regarding CRRT and IRRT fuel this debate. Fluid overload is a recognized and yet clinically underappreciated factor that increases morbidity and mortality in the intensive care unit (ICU). Continuous renal replacement therapy has a distinct advantage over IRRT in achieving euvolemia and thus the potential for improving outcomes in all patients in the ICU setting in which extensive fluid administration is often obligatory. With this in mind, perhaps CRRT should not be restricted to only those patients in whom their hemodynamic status requires it. This article reviews the current literature and the myths that may influence the selection of one mode of therapy over the other among patients requiring renal replacement therapy in the ICU.
Selenium and vitamin E together improve intestinal epithelial barrier function and alleviate oxidative stress in heat‐stressed pigs
Authors: Liu Fan , Cottrell Jeremy J. , Furness John B. , Rivera Leni R. , Kelly Fletcher W. , Wijesiriwardana Udani , Pustovit Ruslan V. , Fothergill Linda J. , Bravo David M. , Celi Pietro , Leury Brian J. , Gabler Nicholas K. , Dunshea Frank R. 
Published: April 2016

New Findings

What is the central question of this study?
Oxidative stress may play a role in compromising intestinal epithelial barrier integrity in pigs subjected to heat stress, but it is unknown whether an increase of dietary antioxidants (selenium and vitamin E) could alleviate gut leakiness in heat‐stressed pigs.

What is the main finding and its importance?
Levels of dietary selenium (1.0 p.p.m.) and vitamin E (200 IU kg−1) greater than those usually recommended for pigs reduced intestinal leakiness caused by heat stress. This finding suggests that oxidative stress plays a role in compromising intestinal epithelial barrier integrity in heat‐stressed pigs and also provides a nutritional strategy for mitigating these effects.

Heat stress compromises the intestinal epithelial barrier integrity of mammals through mechanisms that may include oxidative stress. Our objective was to test whether dietary supplementation with antioxidants, selenium (Se) and vitamin E (VE), protects intestinal epithelial barrier integrity in heat‐stressed pigs. Female growing pigs (n = 48) were randomly assigned to four diets containing from 0.2 p.p.m. Se and 17 IU kg−1 VE (control, National Research Council recommended) to 1.0 p.p.m. Se and 200 IU kg−1 VE for 14 days. Six pigs from each dietary treatment were then exposed to either thermoneutral (20°C) or heat‐stress conditions (35°C 09.00–17.00 h and 28°C overnight) for 2 days. Transepithelial electrical resistance and fluorescein isothiocyanate–dextran (4 kDa; FD4) permeability were measured in isolated jejunum and ileum using Ussing chambers. Rectal temperature, respiratory rate and intestinal HSP70 mRNA abundance increased (all P < 0.001), and respiratory alkalosis occurred, suggesting that pigs were heat stressed. Heat stress also increased FD4 permeability and decreased transepithelial electrical resistance (both P < 0.01). These changes were associated with changes indicative of oxidative stress, a decreased glutathione peroxidase (GPX) activity and an increased glutathione disulfide (GSSG)‐to‐glutathione (GSH) ratio (both P < 0.05). With increasing dosage of Se and VE, GPX‐2 mRNA (P = 0.003) and GPX activity (P = 0.049) increased linearly, the GSSG:GSH ratio decreased linearly (P = 0.037), and the impacts of heat stress on intestinal barrier function were reduced (P < 0.05 for both transepithelial electrical resistance and FD4 permeability). In conclusion, in pigs an increase of dietary Se and VE mitigated the impacts of heat stress on intestinal barrier integrity, associated with a reduction in oxidative stress.
The myths and physiology surrounding intrapartum decelerations: the critical role of the peripheral chemoreflex
Authors: Lear Christopher A. , Galinsky Robert , Wassink Guido , Yamaguchi Kyohei , Davidson Joanne O. , Westgate Jenny A. , Bennet Laura , Gunn Alistair J. 
Published: April 2016

AbstractA distinctive pattern of recurrent rapid falls in fetal heart rate, called decelerations, are commonly associated with uterine contractions during labour. These brief decelerations are mediated by vagal activation. The reflex triggering this vagal response has been variably attributed to a mechanoreceptor response to fetal head compression, to baroreflex activation following increased blood pressure during umbilical cord compression, and/or a Bezold–Jarisch reflex response to reduced venous return from the placenta. Although these complex explanations are still widespread today, there is no consistent evidence that they are common during labour. Instead, the only mechanism that has been systematically investigated, proven to be reliably active during labour and, crucially, capable of producing rapid decelerations is the peripheral chemoreflex. The peripheral chemoreflex is triggered by transient periods of asphyxia that are a normal phenomenon associated with all uterine contractions. This should not cause concern as the healthy fetus has a remarkable ability to adapt to these repeated but short periods of asphyxia. This means that the healthy fetus is typically not at risk of hypotension and injury during uncomplicated labour even during repeated brief decelerations. The physiologically incorrect theories surrounding decelerations that ignore the natural occurrence of repeated asphyxia probably gained widespread support to help explain why many babies are born healthy despite repeated decelerations during labour. We propose that a unified and physiological understanding of intrapartum decelerations that accepts the true nature of labour is critical to improve interpretation of intrapartum fetal heart rate patterns.
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