bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drying Kinetics and Expansion of Non‐predried Extruded Starch‐Based Pellets during Microwave Vacuum Processing
Authors: Kraus Stefan , Sólyom Katalin , Schuchmann Heike P. , Gaukel Volker 
Published: October 2013

AbstractDrying kinetics of extruded, starch‐based pellets with initial moisture content of 0.695 kg/kg d.b. were experimentally investigated in a microwave vacuum drying system. The influence of the initial sample amount (100, 200 and 300 g), microwave power (400, 600 and 800 W) and system pressure (20, 50 and 100 mbar) were examined in detail. An increase in microwave power and a decrease in initial sample amount significantly shortened the drying time. Among several thin layer models, the model of Balbay and Sahin best describes the experimental data for starch‐based pellets. The activation energy was calculated to be 10.89 W/g and effective moisture diffusivity varied from 3.4 × 10−9 to 1.2 × 10−8 m2/s, depending on microwave power level and sample amount.Practical ApplicationThird generation snacks provide an alternative to fully prepared puffed snack foods. In contrast to conventional extrusion, nonexpanded pellets are formed via extrusion, then predried and then expanded to achieve a crispy and porous texture. In this alternative process, the extrusion can be performed at high moisture content, moderate temperature and shearing conditions. This is beneficial for the preservation of thermally and mechanically sensitive ingredients and allows the production of snacks with high nutritional quality. A special feature of the process investigated in this study is that the expansion is achieved by microwave‐vacuum processing which allows an indirect expansion without a time‐ and energy‐consuming predrying process. In addition, due to the processing under vacuum, the temperature inside the product can be kept at desired moderate values. The drying kinetics, drying rate and diffusion coefficient in connection with the volume expansion allow process design and product quality improvement.
Risk factors and clinical outcomes of gastric cancer identified by screening endoscopy: A case–control study
Authors: Gong Eun Jeong , Ahn Ji Yong , Jung Hwoon‐Yong , Lim Hyun , Choi Kwi‐Sook , Lee Jeong Hoon , Kim Do Hoon , Choi Kee Don , Song Ho June , Lee Gin Hyug , Kim Jin‐Ho , Choi Son Yeong , Choe Jae Won , Kim Min‐Ju 
Published: October 2013

AbstractBackground and AimA customized screening program for gastric cancer would optimize the benefits of screening endoscopy. This study investigated the risk factors for gastric cancer detected during screening and factors affecting clinical outcomes.MethodsFrom April 2000 to December 2010, subjects who underwent screening endoscopy at Asan Medical Center were included. To investigate risk factors, age‐ and sex‐matched control group was selected. The clinical outcomes of gastric cancer identified during screening (screening group) were compared with age, sex, and date of diagnosis‐matched subjects who were diagnosed with gastric cancer in the outpatient clinic (outpatient group).ResultsOf 109 530 subjects, 327 were diagnosed with gastric cancer. The median age of the screening group was 63.6 years (interquartile range 56–71 years), and the male‐to‐female ratio was 2.4:1. When comparing with the control group, Helicobacter pylori seropositivity (odds ratio [OR] 2.933, P < 0.001), carcinoembryonic antigen (OR 8.633, P = 0.004), family history of gastric cancer (OR 2.254, P = 0.007), and drinking (OR 3.312, P < 0.001) were independent positive risk factors, and the use of aspirin a negative risk factor for gastric cancer (OR 0.445, P = 0.012) in multivariate analysis. Low‐density lipoprotein cholesterol (hazard ratio [HR] 0.987, P = 0.005), cancer antigen 19‐9 (HR 21.713, P < 0.001), resectability (HR 59.833, P < 0.001), and family history (HR 0.308, P = 0.009) were independent risk factors for death. The 5‐year survival rate was significantly higher in the screening group than in the outpatient group (P < 0.001).ConclusionsEarly detection of gastric cancer by screening endoscopy while asymptomatic enhances patient outcomes, especially in high‐risk groups.
The impact of parental‐rearing styles on irritable bowel syndrome in adolescents: A school‐based study
Authors: Xing Zhouxiong , Hou Xiaohua , Zhou Kan , Qin Diyuan , Pan Wen 
Published: October 2013

AbstractBackground and AimA strong association between family function and irritable bowel syndrome (IBS) has been observed. Parental rearing styles, as a comprehensive mark for family function, may provide new clues to the etiology of IBS. This study aimed to explore which dimensions of parental rearing styles were risk factors or protective factors for IBS in adolescents.MethodsTwo thousand three hundred twenty adolescents were recruited from one middle school and one high school randomly selected from Jiangan District (an urban district in Wuhan City). Data were collected using two Chinese versions of validated self‐report questionnaires including the Rome III diagnostic criteria for pediatric IBS and the Egna Minnen Beträffande Uppfostran: One's Memories of Upbringing for perceived parental rearing styles.ResultsNinety‐six subjects diagnosed as pediatric IBS were compared with 1618 controls. The IBS patients reported less both paternal and maternal emotional warmth (all P < 0.01) and more both paternal and maternal punishment, overinterference, rejection, and overprotection (only for father) (all P < 0.01) than the controls. Furthermore, the IBS patients had higher total scores of parental rearing styles (all P < 0.001) than the controls. With univariate logistic regression, standardized regression coefficients and odds ratios of parental rearing variables were calculated. Multivariate logistic regression revealed that paternal rejection (P = 0.001) and maternal overinterference (P = 0.002) were independent risk factors for IBS in adolescents.ConclusionsParental emotional warmth is a protective factor for IBS in adolescents and parental punishment, overinterference, rejection, and overprotection are risk factors for IBS in adolescents.
Endoscopic resection for duodenal carcinoid tumors: A multicenter, retrospective study
Authors: Kim Gwang Ha , Kim Jin Il , Jeon Seong Woo , Moon Jeong Seop , Chung Il‐Kwun , Jee Sam‐Ryong , Kim Heung Up , Seo Geom Seog , Baik Gwang Ho , Lee Yong Chan ,   The Korean College of Helicobacter and Upper Gastrointestinal Research
Published: October 2013

AbstractBackground and AimGastrointestinal carcinoid tumors < 10 mm in diameter and limited to the submucosal layer demonstrate a low frequency of lymph node and distant metastasis, and are suitable for endoscopic treatment. The aim of this study was to assess the efficacy, safety, and long‐term prognosis of endoscopic resections for the treatment of duodenal carcinoid tumors.MethodsThis study included a total of 41 duodenal carcinoid tumors in 38 patients between January 2006 and December 2011. The indications for endoscopic resection were lesions ≤ 10 mm in diameter, confined to the submucosal layer, and without lymph node or distant metastasis. Endoscopic resection was accomplished using endoscopic mucosal resection (EMR), EMR with a ligation device (EMR‐L), EMR after circumferential precutting, or endoscopic submucosal dissection (ESD).ResultsEMR was performed in 18 tumors, EMR‐L in 16, EMR after circumferential precutting in 3, and ESD in 4. En‐bloc resection was performed in 39 tumors (95%), and endoscopic complete resection was achieved in 40 (98%); pathological complete resection was achieved in 17 tumors (41%). The endoscopic complete resection rate did not differ according to the resection method, but the pathological complete resection rate was higher for ESD than for EMR and EMR‐L. Intraprocedural bleeding was noted in five cases, with no occurrence of perforation. Recurrence was not observed during the mean follow‐up period of 17 months (range 1–53 months).ConclusionEndoscopic resection appears to be a safe and effective treatment for duodenal carcinoid tumors measuring ≤ 10 mm in diameter and confined to the submucosal layer.
Transjugular intrahepatic portosystemic shunt in combination with or without variceal embolization for the prevention of variceal rebleeding: A meta‐analysis
Authors: Qi Xingshun , Liu Lei , Bai Ming , Chen Hui , Wang Juan , Yang Zhiping , Han Guohong , Fan Daiming 
Published: October 2013

AbstractBackground and AimTransjugular intrahepatic portosystemic shunt (TIPS) is the mainstay treatment option for the complications of portal hypertension. Whether or not variceal embolization should be performed during TIPS procedures remains controversial. A meta‐analysis to compare the incidence of shunt dysfunction, variceal rebleeding, encephalopathy, and death between patients treated with TIPS alone and those treated with TIPS combined with variceal embolization was conducted.MethodsAll relevant studies were searched via PubMed, EMBASE, and Cochrane Library databases. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled. Heterogeneity among studies and publication bias were assessed.ResultsSix articles were included in our study. Type of stents was covered (n = 2), bare (n = 2), mixed (n = 1), and unknown (n = 1). Varices were angiographically embolized by coils in six studies. Additional liquids agents were employed in three studies. Compared with TIPS alone group, TIPS combined with variceal embolization group had a significantly lower incidence of variceal rebleeding (OR 2.02, 95% CI 1.29–3.17, P = 0.002), but a similar incidence of shunt dysfunction (OR 1.26, 95% CI 0.76–2.08, P = 0.38), encephalopathy (OR 0.81, 95% CI 0.46–1.43, P = 0.47), and death (OR 0.90, 95% CI 0.55–1.47, P = 0.68). Neither any significant heterogeneity nor proof of publication bias among studies was found in all meta‐analyses.ConclusionsAdjunctive variceal embolization during TIPS procedures might be beneficial in the prevention of variceal rebleeding. However, given the heterogeneity of type of stents, embolic agents, type of varices, and indications of variceal embolization among studies, additional well‐designed randomized, controlled trials with larger sample size and use of covered stents should be warranted to confirm these findings.
Combined therapies versus monotherapies for the first variceal bleeding in patients with high‐risk varices: A meta‐analysis of randomized controlled trials
Authors: Bai Ming , Qi Xingshun , Yang Man , Han Guohong , Fan Daiming 
Published: October 2013

AbstractBackground and AimThe effect of combined therapies (among non‐selected beta‐blockers [NSBB], endoscopic therapy, and other treatments) on the first variceal bleeding has been evaluated in several randomized controlled trials previously, and the results were controversial. We performed this meta‐analysis to assess the effect of combined therapies in patients with high‐risk varices without previous variceal bleeding.MethodsThe Cochrane Library, The Cochrane Hepato‐Biliary Group Controlled Trials Register, MEDLINE, and EMBASE were searched for eligible trials. Manual searches were also performed for additional studies. Upper gastrointestinal bleeding, variceal bleeding, mortality, and adverse events were evaluated as end‐points by meta‐analysis.ResultsTwelve randomized controlled trials with 1571 patients were included. Compared with the NSBB (propranolol or nadolol) or endoscopic therapy alone, all of the combined therapies did not demonstrate significant improvements in variceal bleeding, total upper gastrointestinal bleeding, and mortality. Only the combinations of isosorbide‐mononitrate or spironolactone with NSBB tended to decrease the risk of variceal bleeding when compared with the use of NSBB alone (isosorbide‐mononitrate plus NSBB vs NSBB: odds ratio = 0.67, 95% confidence interval 0.40–1.13, P = 0.13; spironolactone plus NSBB vs NSBB: odds ratio = 0.41, 95% confidence interval 0.10–1.69, P = 0.22). Adverse events were more frequently observed in the combined therapy groups.ConclusionsBased on the available evidences, no combined therapy can be recommended as the first‐line treatment for the primary prevention of variceal bleeding currently. Further studies with large sample sizes and long‐term follow up are warranted.
Prediction of liver stiffness hepatocellular carcinoma in chronic hepatitis C patients on interferon‐based anti‐viral therapy
Authors: Narita Yutaka , Genda Takuya , Tsuzura Hironori , Sato Shunsuke , Kanemitsu Yoshio , Ishikawa Sachiko , Kikuchi Tetsu , Hirano Katsuharu , Iijima Katsuyori , Wada Ryo , Ichida Takafumi 
Published: October 2013

AbstractBackground and AimThe purpose of this study was to evaluate the usefulness of liver stiffness measurement (LSM) for assessing the risk of hepatocellular carcinoma (HCC) in chronic hepatitis C (CHC) patients receiving interferon (IFN) therapy.MethodsOne hundred fifty‐one CHC patients who underwent LSM and received IFN therapy were included in the estimation cohort, and 56 were included in the validation study. The cumulative HCC incidences were evaluated using Kaplan–Meier plot analysis and the log‐rank test. Multivariate Cox proportional hazard analyses were used to estimate the hazard ratios (HRs) of variables for HCC.ResultsIn the estimation cohort, 9 of 151 patients developed HCC during the median follow‐up time of 722 days. Multivariate analysis identified three independent risk factors for HCC: LSM (≥ 14.0 kPa, HR 5.58, P = 0.020), platelet count (< 14.1 × 104/μL, HR 5.59, P = 0.034), and non‐sustained virological response (HR 8.28, P = 0.049). The cumulative incidence of HCC development at 3 years was 59.6%, 8.2%, and 0.0% in patients with all three risk factors, one to two risk factors, and none of these risk factors, respectively. The incidence of HCC was significantly different between these groups (P < 0.001). In the validation cohort, HCC incidence was also significantly different with respect to these risk factors (P = 0.037).ConclusionLSM, platelet count, and IFN‐therapeutic effect could be used to successfully stratify the risk of HCC in patients receiving IFN therapy and demonstrate the usefulness of LSM before IFN therapy for the management of CHC patients.
Nonmotor Symptoms in Nursing Home Residents with Parkinson's Disease: Prevalence and Effect on Quality of Life
Authors: Weerkamp Nico J. , Tissingh Gerrit , Poels Petra J.E. , Zuidema Systse U. , Munneke Marten , Koopmans Raymond T.C.M. , Bloem Bastiaan R. 
Published: October 2013

ObjectivesTo determine the prevalence of nonmotor symptoms (NMS) in nursing home (NH) residents with Parkinson's disease (PD) and to establish the association with quality of life.DesignCross‐sectional.SettingNursing homes in the southeast of the Netherlands.ParticipantsNursing home residents with PD and a Mini‐Mental State Examination score of 18 or greater (N = 73; mean age 78.7, disease duration 10 years, mainly Hoehn and Yahr Stages 4 (38%) and 5 (49%)) underwent detailed examination to determine the prevalence of NMS.MeasurementsValidated instruments for PD‐related NMS were used to examine the NH residents with PD. The overall burden of NMS, and autonomic problems in particular, were measured using the Non‐Motor Symptoms Scale (NMSS). Depression, neuropsychiatric symptoms, sleep problems, cognitive dysfunction, and motor impairments were focused on in further detail using established clinimetric tests. Linear regression analysis was used to examine the relationship between these symptoms and quality of life, which was measured using the Parkinson's Disease Questionnaire (PDQ‐8).ResultsThe NMSS revealed a mean of nearly 13 different NMS per resident. Autonomic problems (constipation, urinary urgency) were particularly prevalent (48–75% of residents). Depressive symptoms were present in 45%. The most prevalent neuropsychiatric symptoms other than depression were irritability and apathy. The most common sleep problems were overall poor nighttime sleep quality, daytime sleepiness, and nocturia. Cognitive problems were highly prevalent, and 77% of the residents met the criteria for PD‐related dementia. High scores were also obtained for motor impairments. Mean PDQ‐8 score was high, indicating poor quality of life. Poor quality of life was most strongly associated with the prevalence and severity of overall NMS burden (coefficient of determination = 0.45).ConclusionNonmotor symptoms were highly prevalent in NH residents with PD. Quality of life was poor, largely because of NMS. Because many NMS are potentially treatable, diagnosis and treatment of these severely affected individuals deserve more attention.
Hospice Use and Public Expenditures at the End of Life in Assisted Living Residents in a Florida Medicaid Waiver Program
Authors: Meng Hongdao , Dobbs Debra , Wang Su , Hyer Kathryn 
Published: October 2013

ObjectivesTo examine the association between hospice use and public expenditures in a sample of dually eligible assisted living (AL) residents at the end of life.DesignA retrospective cohort study.SettingFlorida AL facilities.ParticipantsNewly enrolled dually eligible older AL residents under Florida's Medicaid Assisted Living for the Elderly waiver program who died between January 2003 and December 2004 (N = 382).MeasurementsIndividual sociodemographic characteristics were obtained from Florida's Medicaid comprehensive assessment data. Medicaid eligibility status, enrollment in the AL waiver programs, International Classification of Diseases, Ninth Revision, Clinical Modification, codes and Medicaid claims data were obtained from Florida's Medicaid payment agency. Individual characteristics and Medicare and Medicaid claims data were merged with vital statistics to determine diagnoses, date of death, hospice enrollment, and public expenditures.ResultsThe mean age of the study sample was 84.8 (range 65–102); 71.5% were female, and 63.4% were white. During the average 9.6 months of follow‐up, 35.6% of the sample enrolled in hospice, and the average hospice length of stay was 47.9 d; 73.3% of the sample had been admitted to a hospital, and 38.0% had been admitted to a nursing home. The generalized linear model showed that hospice use was not significantly associated with lower public expenditures (average marginal effect = −$1,127, 95% confidence interval = −$8,377, $6,122).ConclusionHospice use at the end of life may not be associated with lower public expenditures in older dually eligible AL residents. Future research should examine the association between hospice enrollment and the quality of end‐of‐life care.
Vitamin D and Physical Performance in Older Men and Women Visiting the Emergency Department Because of a Fall: Data from the Improving Medication Prescribing to reduce Risk Of FALLs (IMPROveFALL) Study
Authors: Boyé Nicole D. A. , Oudshoorn Christian , van der Velde Nathalie , van Lieshout Esther M. M. , de Vries Oscar J. , Lips Paul , van Beeck Ed F. , Patka Peter , van der Cammen Tischa J. M. 
Published: October 2013

ObjectivesTo investigate whether serum 25‐hydroxy vitamin D (25(OH)D) is associated with physical performance in men and women.DesignCross‐sectional.SettingEmergency departments (EDs) of five hospitals.ParticipantsOlder adults who visited an ED because of a fall (N = 616).MeasurementsPhysical performance was assessed using the Timed Up and Go Test, the Five Time Sit to Stand Test, handgrip strength, and the tandem stand test. Multivariate linear regression was used to assess the association between physical performance and log‐transformed 25(OH)D concentration adjusted for potential confounders.ResultsIn men, higher serum 25(OH)D concentration was significantly associated with better handgrip strength (regression coefficient (B) = 3.86, 95% confidence interval (CI) = 2.04−5.69), faster TUG time (B = −2.82, 95% CI = −4.91 to −0.73), and faster FTSS time (B = −3.39, 95% CI = −5.67 to −1.11). In women, higher serum 25(OH)D concentration was significantly associated with faster TUG time (B = −2.68, 95% CI = −4.87 to −0.49).ConclusionA positive association was found between serum 25(OH)D level and physical performance in men and women. Intervention studies are needed of vitamin D–deficient older men and women to further investigate the effect of vitamin D supplementation in this group.
Development of exchange lists for Mediterranean and Healthy Eating Diets: implementation in an intervention trial
Authors: Sidahmed E. , Cornellier M. L. , Ren J. , Askew L. M. , Li Y. , Talaat N. , Rapai M. S. , Ruffin M. T. , Turgeon D. K. , Brenner D. , Sen A. , Djuric Z. 
Published: October 2013

AbstractBackgroundThere has been little research published on the adaptation of diabetic exchange list diet approaches for the design of intervention diets in health research despite their clinical utility. The exchange list approach can provide clear and precise guidance on multiple dietary changes simultaneously. The present study aimed to develop exchange list diets for Mediterranean and Healthy Eating, and to evaluate adherence, dietary intakes and markers of health risks with each counselling approach in 120 subjects at increased risk for developing colon cancer.MethodsA randomised clinical trial was implemented in the USA involving telephone counselling. The Mediterranean diet had 10 dietary goals targeting increases in mono‐unsaturated fats, n‐3 fats, whole grains and the amount and variety of fruits and vegetables. The Healthy Eating diet had five dietary goals that were based on the US Healthy People 2010 recommendations.ResultsDietary compliance was similar in both diet arms, with 82–88% of goals being met at 6 months, although subjects took more time to achieve the Mediterranean goals than the Healthy Eating goals. The relatively modest fruit and vegetable goals in the Healthy Eating arm were exceeded, resulting in fruit and vegetable intakes of approximately eight servings per day in each arm after 6 months. A significant (P < 0.05) weight loss and a decrease in serum C‐reactive protein concentrations were observed in the overweight/obese subgroup of subjects in the Mediterranean arm in the absence of weight loss goals.ConclusionsCounselling for the Mediterranean diet may be useful for both improving diet quality and for achieving a modest weight loss in overweight or obese individuals.
Consumption‐based Material Flow Accounting
Authors: Schaffartzik Anke , Eisenmenger Nina , Krausmann Fridolin , Weisz Helga 
Published: October 2013

SummaryIn 2007, imports accounted for approximately 34% of the material input (domestic extraction and imports) into the Austrian economy and almost 60% of the GDP stemmed from exports. Upstream material inputs into the production of traded goods, however, are not yet included in the standard framework of material flow accounting (MFA). We have reviewed different approaches accounting for these upstream material inputs, or raw material equivalents (RME), positioning them in a wider debate about consumption‐based perspectives in environmental accounting. For the period 1995–2007, we calculated annual RME of Austria's trade and consumption applying a hybrid approach. For exports and competitive imports, we used an environmentally extended input‐output model of the Austrian economy, based on annual supply and use tables and MFA data. For noncompetitive imports, coefficients for upstream material inputs were extracted from life cycle inventories. The RME of Austria's imports and exports were approximately three times larger than the trade flows themselves. In 2007, Austria's raw material consumption was 30 million tonnes or 15% higher than its domestic material consumption. We discuss the material composition of these flows and their temporal dynamics. Our results demonstrate the need for a consumption‐based perspective in MFA to provide robust indicators for dematerialization and resource efficiency analysis of open economies.