bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of clinical guidelines in cardiology practice in Sudan
Authors: Elsadig Hwaida , Weiss Marjorie , Scott Jenny , Laaksonen Raisa 
Published: June 2017

AbstractRationale, aims, and objectiveThe aim of this study was to explore the views of prescribers in cardiology in Sudan about the use of guidelines in clinical practice and the extent to which guidelines whether national or international can be adopted in clinical practice in Sudan.MethodsInterviews were conducted with the consultants in 2 of the main cardiac hospitals in Sudan. This was followed by a survey amongst the doctors in the hospitals to examine the views of a larger population of prescribers about the matter investigated.ResultsTwelve consultants were interviewed, and 47 prescribers (60%) replied to the questionnaire that followed. Most doctors relied on foreign guidelines to prescribe for their patients. The doctors acknowledged the limitation of using foreign guidelines in Sudan. A number of doctors were not in favour of following any guidelines, as they perceived that the practice in Sudan does not allow implementation of guidelines.ConclusionThe prescribers in Sudan had to rely on guidelines made in foreign countries if they want to get the benefit of evidence‐based medicine to their patients, but they had to find a way to adapt these guidelines to their patients and to the health care system they are working within. However, it is not known if this adaptation of foreign guidelines is providing the benefits intended or is risking evidence‐based medicine.
Biorefining of filter tea factory by‐products: Classical and ultrasound‐assisted extraction of bioactive compounds from wild apple fruit dust
Authors: Naffati Abdulhakim , Vladić Jelena , Pavlić Branimir , Vidović Senka 
Published: June 2017

AbstractIn this study, two methods of extraction (classical and ultrasound assisted) have been applied to utilize the wild apple fruit dust‐by product from a filter tea factory. According to the results obtained, the total phenols content in the wild apple fruit dust ranged from 777.003 to 1,148.030 mg GAE/100 g of investigated material. These results indicate the high potential for utilization of wild apple fruit dust in terms of extraction and production of extracts with a high concentration of phenolic constituents. For optimization of a more efficient method of extraction, in this case ultrasound‐assisted, a response surface methodology was applied. Temperature and time interaction proved to be the most dominant and highly significant factor for the extraction of total phenolics from this kind of raw material. On the other hand, linear terms of temperature and the interaction of time and ultrasonic power had a significant effect on the extraction of total flavonoids. The antioxidant activity of the extracts obtained was particularly high: in the range of .0211 to .0279 mg/mL.Practical applicationsThis is a new manuscript exploring possibility of utilization of wild apple by‐product/waste (“apple fruit dust”) obtained during the production of fruit filter tea in filter tea industry. Possibility of wild apple dust biorefining was observed through investigation of classical (CE) and ultrasound‐assisted extraction (UAE). Based on results of extraction yield, and extracted total phenols and total flavonoids, obtained in CE, most favorable extraction solvent was selected for further processing. Results are presenting a great value of such new by‐products (much higher in comparison to those well presented in literature) and also advantage of used and investigated extraction techniques which could be used for its processing.
An evaluation of the feasibility and validity of a patient‐administered malnutrition universal screening tool (‘MUST’) compared to healthcare professional screening in an inflammatory bowel disease (IBD) outpatient clinic
Authors: Keetarut K. , Zacharopoulou‐Otapasidou S. , Bloom S. , Majumdar A. , Patel P. S. 
Published: June 2017

AbstractBackgroundMalnutrition is common in inflammatory bowel disease (IBD) and is associated with poor health outcomes. Despite this, screening for malnutrition in the outpatient‐setting is not routine and research in the area is limited. The present study aimed to evaluate whether agreement between malnutrition screening completed by patients and healthcare professionals (HCPs) could be achieved by comparing patient self‐administered ‘MUST’ (‘MUST’‐P) with HCP administered ‘MUST’ (‘MUST’‐HCP) in a single tertiary IBD outpatient clinic.MethodsWe conducted a feasibility and validity study on adult outpatients with IBD. We collected anthropometric, nutritional and clinical data from patients. All patients completed ‘MUST’‐P using a self‐administered questionnaire, followed by ‘MUST’‐HCP. ‘MUST’‐P was timed and feedback on ease‐of‐use was obtained. The risk of malnutrition was classified as low (score = 0), medium (score = 1) and high (score ≥ 2) and agreement was tested using kappa statistics (κ).ResultsEighty patients were recruited (Crohn's disease: n = 49, ulcerative colitis: n = 29, unclassified: n = 2), with a mean (SD) age of 39.9 (15.1) years (51.2% were males). Seventy‐one (92%) of patients found ‘MUST’‐P either easy or very easy. The mean (SD) time to complete ‘MUST’‐P was 3.1 (1.8) min (range 1–10 min). Sixty‐eight (85%) of patients were at low risk of malnutrition when screened by the HCP. There was moderate agreement (κ = 0.486, P < 0.001) between ‘MUST’‐P and ‘MUST’‐HCP, with 100% agreement in scoring for medium‐ and high‐risk categories.ConclusionsThe results of the present study suggests that self‐screening using ‘MUST’ could be effectively used in an IBD outpatient clinic to identify those at medium and high risk of malnutrition. The patient friendly version of ‘MUST’ (‘MUST’‐P) was considered quick and easy to use by patients. Implementation of self‐screening with ‘MUST’ could improve the nutritional management of IBD patients.
Are energy and protein requirements met in hospital?
Authors: Pullen K. , Collins R. , Stone T. , Carter H. , Sadler H. , Collinson A. 
Published: June 2017

AbstractBackgroundMalnutrition is a problem within hospitals, which impacts upon clinical outcomes. The present audit assesses whether a hospital menu meets the energy and protein standards recommended by the British Dietetic Association's (BDA) Nutrition and Hydration Digest and determines the contribution of oral nutrition supplements (ONS) and additional snacks.MethodsPatients in a UK South West hospital were categorised as ‘nutritionally well’ or ‘nutritionally vulnerable’ in accordance with their Malnutrition Universal Screening Tool score. Energy and protein content of food selected from the menu (‘menu choice’), menu food consumed (‘hospital intake’) and total food consumed including snacks (‘overall intake’) were calculated and compared with the standards.ResultsIn total, 93 patients were included. For ‘nutritionally well’ patients (n = 81), energy and protein standards were met by 11.1% and 33.3% (‘menu choice’); 7.4% and 22.2% (‘hospital intake’); and 14.8% and 28.4% (‘overall intake’). For ‘nutritionally vulnerable’ patients (n = 12), energy and protein standards were met by 0% and 8.3% (‘menu choice’); 0% and 8.3% (‘hospital intake’); and 8.3% and 16.7% (‘overall intake’). Ten percent of patients consumed ONS. Patients who consumed hospital snacks (34%) were more likely to meet the nutrient standards (P ≤ 0.001).ConclusionsThe present audit demonstrated that most patients are not meeting the nutrient standards recommended by the BDA Nutrition and Hydration Digest. Recommendations include the provision of energy/protein‐dense snacks, as well as menu, offering ONS where clinically indicated, in addition to training for staff. A food services dietitian is ideally placed to lead this, forming a vital link between patients, caterers and clinical teams.
Renewable Energy and Carbon Management in the Cradle‐to‐Cradle Certification: Limitations and Opportunities
Authors: Niero Monia , Olsen Stig I. , Laurent Alexis 
Published: June 2017

SummaryAs part of the Cradle to Cradle® (C2C) certification program, the C2C certification criterion, Renewable Energy and Carbon Management (RE&CM), focuses on use of electricity from renewable energy (RE) and direct greenhouse gas offsets in the manufacturing stage and, to a limited extent, on the cradle to gate only at the highest level of certification. The aim of this study is to provide decision makers with a quantified overview of possible limitations of that C2C certification requirement and potential gains by introducing a full life cycle assessment (LCA) perspective to the scheme. Scenario analysis was used to perform an LCA of an aluminum can system representing different levels of the C2C certification criterion, RE&CM, considering different strategies to achieve 100% RE in the manufacturing stage. The adoption of a broader life cycle RE perspective was considered through the implementation of electricity from renewable sources from cradle to grave. Our results show that compliance with the current RE&CM certification framework offers limited benefits, that is, significant reduction for climate change, but negligible reductions for other environmental impacts (e.g., particulate matter and acidification). However, increasing the share of RE in the primary aluminum production from a full life cycle perspective can greatly increase the environmental benefits brought up by the C2C certification not only for climate change, but also for the broader range of impact categories. In our striving toward environmental sustainability, which often cannot be approximated by climate‐change impacts alone, we therefore recommend decision makers in industries to combine the C2C certification with LCA when they define strategies for the selection of RE and raw materials suppliers.
The Nexus of Carbon, Nitrogen, and Biodiversity Impacts from Urban Metabolism
Authors: Singh Shweta , Kennedy Christopher 
Published: June 2017

SummaryMethodology is developed for linking the urban metabolism (UM) to global environmental stresses on the carbon (C) cycle, nitrogen (N) cycle, and biodiversity loss. UM variables are systematically mapped to the drivers of carbon, nitrogen, and biodiversity impacts. Change in mean species abundance is used as metric of biodiversity loss, by adopting the dose‐response relationships from the GLOBIO model. The main biodiversity drivers related to UM included here are land‐use change (LUC) and atmospheric N deposition. The methodology is demonstrated by studying the nexus for Shanghai in 2006, based on energy and soybean consumption. Results for Shanghai show a strong nexus between C, N, and biodiversity impact due to electricity consumption and energy used in manufacturing industries and construction. Prioritization of the shift away from coal energy will therefore lead to lowering the urban growth impact on all three dimensions. Road transportation, domestic aviation, and the metal industry impact only the C footprint highly, whereas district energy impacts only biodiversity loss highly, showing a weak nexus. Among the global impacts of soybean consumption in Shanghai on biodiversity loss (due to LUC only), the highest impact occurs in Uruguay (0.52%) followed by Brazil (0.05%) and Argentina (0.02%). The local impact on biodiversity loss (i.e., within China) of soybean consumption in Shanghai is 1.03%. However, the methodology and results are limited due to the partial inclusion of drivers, a carbon footprint based on carbon dioxide emissions only, and limitations of biodiversity loss models. Potential to overcome methodological limitations is discussed.
Wii‐based exercise program to improve physical fitness, motor proficiency and functional mobility in adults with Down syndrome
Authors: Silva V. , Campos C. , Sá A. , Cavadas M. , Pinto J. , Simões P. , Machado S. , Murillo‐Rodríguez E. , Barbosa‐Rocha N. 
Published: June 2017

AbstractBackgroundPeople with Down syndrome (DS) usually display reduced physical fitness (aerobic capacity, muscle strength and abnormal body composition), motor proficiency impairments (balance and postural control) and physical functional limitations. Exergames can be an appealing alternative to enhance exercise engagement and compliance, whilst improving physical fitness and motor function. This study aims to analyse the effects of a Wii‐based exercise program on physical fitness, functional mobility and motor proficiency of adults with DS.MethodsTwenty‐seven adults with DS were randomly allocated to an experimental group (Wii; n = 14) or control group (n = 13). Participants in the experimental group completed a 2‐month Wii‐based exercise program, with three 1‐h sessions per week that included training games for aerobic endurance, balance and isometric strength. Participants completed assessments regarding anthropometric measures, physical fitness, functional mobility and motor proficiency.ResultsMixed ANOVA analysis showed a significant group by time interaction for aerobic endurance, explosive leg power and flexibility. Independent samples t‐test for change scores indicated significant between‐group differences favouring the experimental group regarding speed of limb movement, trunk strength and functional mobility, as well as a trend towards significance on body weight. Mann–Whitney's U test for change scores demonstrated between‐group differences favouring the experimental group for visceral fat as well as running speed and agility. Large within‐group effect sizes were observed for explosive leg power (d = 1.691), body weight (d = 1.281), functional mobility (d = 1.218), aerobic endurance (d = 1.020), speed of limb movement (d = 0.867) and flexibility (d = 0.818) in the experimental group.ConclusionsOur findings suggest that Wii‐based exercise can be an effective tool to improve physical fitness, functional mobility and motor proficiency of adults with DS, including crucial measures such as aerobic capacity and lower limb strength. Exergames using Wii Fit or other equipment can be appealing alternatives for adults with DS to engage in regular physical activity, preventing sedentary behaviour and decreasing the risk to develop cardiovascular diseases.
Maternal antibodies against tetanus toxoid do not inhibit potency of antibody responses to autologous antigen in newborn rhesus monkeys
Authors: Veazey Ronald S. , Lu Yingjie , Xu Huanbin , Ziani Widade , Doyle‐Meyers Lara A. , Ratterree Marion S. , Wang Xiaolei 
Published: June 2017

AbstractBackgroundOur previous study suggested newborns have competent immune systems with the potential to respond to foreign antigens and vaccines. In this study, we examined infant immune responses to tetanus toxoid (TT) vaccination in the presence of maternal antibody to TT.MethodsWe examined changes in plasma levels of tetanus toxoid‐specific IgG1 (anti‐TT IgG1) in a total of eight infant rhesus macaques from birth through 6 months of age using a commercial Monkey Anti‐TT IgG1 ELISA kit.ResultsA significant correlation between anti‐TT IgG1 levels in vaccinated dams and their paired newborn infants was detected in control (non‐vaccinated) infants as previously reported. Maternal anti‐TT IgG1 levels declined rapidly within 1 month of birth in non‐vaccinated infants (n=4). In four infants vaccinated with TT at birth, we found two had rapid and robust antibody responses to vaccination. Interestingly, the other two first showed declining TT antibody levels for 2 weeks followed by increasing levels without additional vaccine boosts, indicating all four had good antibody responses to primary TT vaccination at birth, despite the presence of high levels of maternal antibodies to TT in all four infants.ConclusionsOur data indicate that newborn macaques have competent immune systems that are capable of generating their own primary antibody responses to vaccination, at least to tetanus antigens. Maternal antibodies thus do not significantly impair antibody response to the vaccination, even when received on the day of birth in infant rhesus macaques.
Closure of the vertebral canal in human embryos and fetuses
Authors: Mekonen Hayelom K. , Hikspoors Jill P. J. M. , Mommen Greet , Kruepunga Nutmethee , Köhler S. Eleonore , Lamers Wouter H. 
Published: June 2017

AbstractThe vertebral column is the paradigm of the metameric architecture of the vertebrate body. Because the number of somites is a convenient parameter to stage early human embryos, we explored whether the closure of the vertebral canal could be used similarly for staging embryos between 7 and 10 weeks of development. Human embryos (5–10 weeks of development) were visualized using Amira 3D® reconstruction and Cinema 4D® remodelling software. Vertebral bodies were identifiable as loose mesenchymal structures between the dense mesenchymal intervertebral discs up to 6 weeks and then differentiated into cartilaginous structures in the 7th week. In this week, the dense mesenchymal neural processes also differentiated into cartilaginous structures. Transverse processes became identifiable at 6 weeks. The growth rate of all vertebral bodies was exponential and similar between 6 and 10 weeks, whereas the intervertebral discs hardly increased in size between 6 and 8 weeks and then followed vertebral growth between 8 and 10 weeks. The neural processes extended dorsolaterally (6th week), dorsally (7th week) and finally dorsomedially (8th and 9th weeks) to fuse at the midthoracic level at 9 weeks. From there, fusion extended cranially and caudally in the 10th week. Closure of the foramen magnum required the development of the supraoccipital bone as a craniomedial extension of the exoccipitals (neural processes of occipital vertebra 4), whereas a growth burst of sacral vertebra 1 delayed closure until 15 weeks. Both the cranial‐ and caudal‐most vertebral bodies fused to form the basioccipital (occipital vertebrae 1–4) and sacrum (sacral vertebrae 1–5). In the sacrum, fusion of its so‐called alar processes preceded that of the bodies by at least 6 weeks. In conclusion, the highly ordered and substantial changes in shape of the vertebral bodies leading to the formation of the vertebral canal make the development of the spine an excellent, continuous staging system for the (human) embryo between 6 and 10 weeks of development.
Psychometric validation of the Chinese version of the Illness Perception Questionnaire–Revised for women with stress urinary incontinence
Authors: Fan Yijun , Huang Zhaohui , Zhang Dazhao , Chang Jun , Jia Yun , He Shuihong , Wei Bing 
Published: June 2017

AbstractAimThe aim of this study was to examine the reliability and validity of the Illness Perception Questionnaire–Revised (IPQ‐R) in patients with stress urinary incontinence (SUI).MethodsA total of 256 patients with SUI and 76 patients with myoma of the uterus were recruited to complete the Chinese IPQ‐R. For the reliability, the key tests included Cronbach's α coefficient and intraclass correlation coefficients. For the validity, the key tests included factor analysis, Spearman's correlation coefficient, and the Student's t‐test.ResultsCronbach's α values ranged from 0.68 to 0.90 for each subscale and the intraclass correlation coefficients ranged from 0.80 to 0.94. The results of the confirmatory factor analysis showed that the seven‐factor structure as proposed by the original IPQ‐R fit the data poorly. Although removal of three items improved the model's fit, the goodness‐of‐fit statistics were still below acceptable standards. We identified an acceptable seven‐factor solution from the 38 items on Illness Beliefs using an exploratory factor analysis (EFA), which accounted for 68.12% of the variance. For the concurrent validity, Consequences and Emotional Representation both had good correlations with anxiety and depression (r = 0.52–0.62) and better quality of life (r = 0.58–0.73). The inter‐correlation coefficient of the seven factors ranged from 0.05 to 0.59, suggesting acceptable discriminant validity. There were significant differences on the scale scores of Disease Identity (t = 9.39, P < 0.01), Timeline–Acute/Chronic (t = 3.69, P < 0.01), Consequences (t = 4.53, P < 0.01), Illness Coherence (t = 7.73, P < 0.01), Timeline–Cyclical (t = 6.48, P < 0.01), Emotional Representation (t = 6.40, P < 0.01), and Cause (t = 4.29, P < 0.01) between the patients with SUI and with myoma of the uterus, which also indicated acceptable discriminant validity.ConclusionThe findings of this study supported the Chinese IPQ‐R as being a reliable and valid tool for measuring illness perception among patients with SUI.
Immunosurveillance profile of oral squamous cell carcinoma and oral epithelial dysplasia through dendritic and T‐cell analysis
Authors: Pellicioli Ana Carolina Amorim , Bingle Lynne , Farthing Paula , Lopes Márcio Ajudarte , Martins Manoela Domingues , Vargas Pablo Agustin 
Published: June 2017

Oral squamous cell carcinomas (OSCCs) can arise from potentially malignant disorders, such as leukoplakia. The immune system plays an important role recognizing tumour precursor cells. However, due to immuno‐editing mechanisms cancer cells are able to escape immune system surveillance.ObjectiveTo evaluate the profile of dendritic (Langerhans and plasmacytoid) and T cells in OSCC and oral epithelial dysplasia (OED) and correlate these findings with clinical data.Materials and MethodsFifty cases of OSCC and 48 of OED were immunostained for CD1a and CD83 dendritic Langerhans cells (DLC), CD303 plasmacytoid dendritic cells (pDC) and CD8 followed by quantitative analysis.ResultsAnalysis revealed a significant decrease in the number of mature CD83 DLC in OSCC compared with OED. CD303 positivity was significantly increased in the OSCC group when compared to OED. CD8‐positive lymphocytes were significantly decreased in OSCC compared with OED lesions. No statistical correlation was found with clinical data.ConclusionThe number of mature dendritic cells (DC) was decreased in OSCC compared with OED lesions suggesting that either these cells might have migrated to lymph nodes to present the tumour antigens and activate the immune system or cytokines secreted by the tumour microenvironment are inhibiting the adequate maturation of DLC. The numbers of pDC were significantly increased in the OSCC group compared with the OED group. This suggests they may play an important role in the defence against tumours although it is not clear whether this is promoting or inhibiting malignant progression.