MUST

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  • 文章类型: Journal Article
    背景:在炎症性肠病(IBD)患者中,代谢功能障碍相关的脂肪变性肝病(MASLD)和营养不良的风险可以共存。作为IBD患者标准随访的一部分,我们进行了营养不良风险评估,并根据是否存在MASLD研究了存在营养不良风险的潜在风险因素。
    方法:使用营养不良通用筛查工具(MUST)筛查营养不良风险(MUST≥1)和受控衰减参数(CAP≥248dB/min)以评估MASLD。坚持地中海饮食,身体活动,和生活质量也被评估。
    结果:在686名评估的IBD患者中,130人(18.9%)被确定存在营养不良风险。没有MASLD的患者(n=89[68.5%])比有MASLD的患者(n=41[31.5%])更有风险,p=0.005)。然而,在有营养不良风险的患者中,与没有MASLD的患者相比,有MASLD的患者更可能患有活动性IBD(82.9%)(39.3%,p<0.001)。女性性别(OR1.984,p=0.027)和年轻年龄(OR1.014,p=0.006)仅在无MASLD的IBD患者中与营养不良风险相关。处于营养不良的风险与更差的生活质量相关(p<0.001)。尤其是IBD患者的MASLD。
    结论:IBD患者中MASLD的存在改变了营养不良风险和生活质量。
    BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) and risk of malnutrition can coexist in patients with inflammatory bowel disease (IBD). We performed a malnutrition risk assessment as part of the standard follow-up of IBD patients and studied the potential risk factors for being at risk of malnutrition based on the presence or absence of MASLD.
    METHODS: The Malnutrition Universal Screening Tool (MUST) was used to screen malnutrition risk (MUST ≥ 1) and controlled attenuation parameter (CAP ≥ 248 dB/min) to assess MASLD. Adherence to a Mediterranean diet, physical activity, and quality of life were also assessed.
    RESULTS: Of 686 evaluated IBD patients, 130 (18.9%) were identified as being at risk of malnutrition. Patients without MASLD (n=89 [68.5%]) were more likely to be at risk than those with MASLD (n=41 [31.5%], p=0.005). However, among patients at risk of malnutrition, those with MASLD were more likely to have active IBD (82.9%) than patients without MASLD (39.3%, p<0.001). Female sex (OR 1.984, p=0.027) and young age (OR 1.014, p=0.006) were associated with malnutrition risk only in patients with IBD without MASLD. Being at risk of malnutrition was associated with worse quality of life (p<0.001), especially in IBD patients with MASLD.
    CONCLUSIONS: Malnutrition risk and quality of life are modified by the presence of MASLD in IBD patients.
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  • 文章类型: Journal Article
    患有神经系统疾病的老年人的营养不良风险(MR)很高,但是在这个群体中几乎没有证据证明经过验证的筛查工具,以及与高MR相关的临床和社会经济因素。
    为了确定使用营养不良通用筛查工具(MUST)的MR与患有神经系统疾病的老年人的死亡率和住院时间(LOS)的关联。其次,临床的关联,并寻求MR和临床结局的社会经济因素.
    在墨西哥三级神经疾病转诊中心进行了一项回顾性队列研究。考虑2017年1月至2018年12月收治的所有60岁以上的患者。必须,在入院时评估临床和社会经济因素.结果随访至出院或最长6个月。
    共纳入765名患者,其中24.7%(n=189)处于高风险。高MR与死亡率(OR3.09;95%CI1.60-5.98,p=.001)和LOS>14天(OR4.38;95%CI2.79-6.89,p=<.001)独立相关。与高MR独立相关的唯一因素是经济依赖和失业。具有高MR和经济依赖性(OR4.0;95%CI1.34-11.99,p=.013)或失业(OR3.43;95%CI1.17-10.06,p=.025)的患者死亡率最高。
    在患有神经系统疾病的住院老年人中,高MR与死亡率和LOS增加独立相关.经济依赖或失业与高MR患者更差的临床结果相关。
    UNASSIGNED: Malnutrition risk (MR) in older adults with neurological disorders is high, but there is little evidence for validated screening tools in this group, as well as for the clinical and socioeconomic factors associated with a high MR.
    UNASSIGNED: To determine the association of MR using the Malnutrition Universal Screening Tool (MUST) with mortality and length of stay (LOS) in older adults with neurological diseases. Secondarily, the association of clinical, and socioeconomic factors with MR and clinical outcomes was sought.
    UNASSIGNED: A retrospective cohort study was carried out at a third-level neurological disease referral center in Mexico. All patients older than 60 years admitted from January 2017 to December 2018 were considered. MUST, clinical and socioeconomic factors were assessed at hospital admission. Outcomes were followed up to hospital discharge or a maximum of 6 months.
    UNASSIGNED: A total of 765 patients were included, of whom 24.7% (n = 189) were at high risk. A high MR was independently associated with mortality (OR 3.09; 95% CI 1.60-5.98, p = .001) and LOS >14 days (OR 4.38; 95% CI 2.79-6.89, p = <.001). The only factors independently associated with high MR was economic dependence and unemployment. Patients with high MR and economic dependence (OR 4.0; 95% CI 1.34-11.99, p = .013) or unemployment (OR 3.43; 95% CI 1.17-10.06, p = .025) had the highest mortality.
    UNASSIGNED: In hospitalized older adults with neurological diseases, high MR is independently associated with increased mortality and LOS. Economic dependence or unemployment are associated with worse clinical outcomes in patients with high MR.
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  • 文章类型: Journal Article
    背景:由于人口老龄化,髋部骨折越来越受到关注。医疗保健系统的高成本和对受影响者的深远影响,包括失去独立性和死亡率上升,让这个问题变得重要。营养不良是老年患者的常见问题,并且与预后较差有关。营养筛查工具可以帮助识别高危患者,并实现个性化护理,以提高生存率。
    方法:这项回顾性研究使用卡方检验,调查了对60岁以上患者股骨近端骨折手术治疗后1、3、6和12个月/s后死亡率的四个营养评分和实验室参数的预测意义。Cox回归分析,和接收机工作特性(ROC)。欧洲临床营养与代谢学会(ESPEN)指南被用作患者各自营养状况筛查的一部分。特别是过滤掉营养不良。
    结果:本研究共纳入1080例患者,而8.05%的人营养不良,定义为体重指数(BMI)低于18.5kg/m2。迷你营养评估(MNA)筛查工具确定的营养不良患者比例最高,为14.54%。根据三个营养评分,总共有36.39%的患者有营养不良的风险,MNA占比最大,为41.20%。被确定为营养不良的患者死亡率较高,而MNA筛查是在所有调查间隔中显示与术后死亡率显著相关的唯一工具.MNA在筛查工具中表现出最佳的预测意义,术后12个月最大曲线下面积(AUC)为0.7。
    结论:MNA筛查在术后死亡率方面具有坚实的相关性和预测意义,因此建议在骨科/创伤病房常规实施该筛查。此外,营养替代疗法可以提供相对便宜且易于实施的措施。格拉茨营养不良筛查(GMS)显示出中等的预测能力,可以考虑作为60岁以下患者的替代方案。较高的白蛋白水平与提高的生存概率相关。但不能说明营养状况。
    BACKGROUND: Hip fractures are becoming a growing concern due to an aging population. The high costs to the healthcare system and far-reaching consequences for those affected, including a loss of independence and increased mortality rates, make this issue important. Poor nutritional status is a common problem among geriatric patients and is associated with a worse prognosis. Nutritional screening tools can help identify high-risk patients and enable individualized care to improve survival rates.
    METHODS: This retrospective study investigates four nutritional scores and laboratory parameters\' predictive significance concerning postoperative mortality after surgical treatment of proximal femur fractures at 1, 3, 6, and 12 month/s for patients over 60 years using the chi-square test, Cox regression analysis, and receiver operating characteristics (ROC). The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines were used as part of the screening of the respective nutritional status of the patients, in particular to filter out malnutrition.
    RESULTS: A total of 1080 patients were included in this study, whereas 8.05% suffered from malnutrition, defined as a body mass index (BMI) below 18.5 kg/m2. The Mini Nutritional Assessment (MNA) screening tool identified the highest proportion of malnourished patients at 14.54%. A total of 36.39% of patients were at risk of malnutrition according to three nutrition scores, with MNA providing the most significant proportion at 41.20%. Patients identified as malnourished had a higher mortality rate, and MNA screening was the only tool to show a significant correlation with postoperative mortality in all survey intervals. The MNA presented the best predictive significance among the screening tools, with a maximum area under the curve (AUC) of 0.7 at 12 month postoperatively.
    CONCLUSIONS: MNA screening has a solid correlation and predictive significance regarding postoperative mortality-therefore routine implementation of this screening in orthopedic/traumatology wards is recommended. Moreover, nutritional substitution therapy can offer a relatively inexpensive and easy-to-implement measure. The Graz malnutrition screening (GMS) shows moderate predictive power and could be considered as an alternative for patients under 60 years of age. A higher albumin level is associated with improved survival probability, but cannot be indicative of nutritional status.
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  • 文章类型: Journal Article
    文献中的初步证据表明,严重获得性脑损伤(sABI)患者营养不良(营养不良)的患病率很高,对临床结局和压疮(PU)的预期负面影响。在一项关于从重症监护病房(ICU)出院并进入重症康复病房(IRU)的患者的回顾性队列研究中,系统评估了营养不良的风险,除了标准的临床程序(包括PU评估)之外,使用两种不同的工具:营养不良通用筛查工具(MUST)和控制营养状况(CONUT)工具。88例患者纳入分析。高比例(79.5%)的sABI患者患有PU,年纪大了,更经常是男人,从事件到IRU入院之间的ICU停留时间更长,一个更大的分数。出院时,当与PU已经愈合的患者相比时,坚持使用PU的人更多是男性,并且在入院时认知表现最差.至于营养风险,通过logistic回归模型,基线CONUT评分被确定为出院时PUs的独立阴性预测因子.总之,使用简单的标准工具评估营养风险可能有助于sABI伴PU患者的临床评估.
    Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an expected negative impact on clinical outcomes and pressure ulcers (PUs) in particular. In a retrospective cohort study on patients discharged from intensive care units (ICU) and admitted to an intensive rehabilitation unit (IRU), the risk of malnutrition was systematically assessed, in addition to standard clinical procedures (including PUs evaluation), using two different tools: the Malnutrition Universal Screening Tool (MUST) and the Controlling Nutritional Status (CONUT) tool. Eighty-eight patients were included in the analysis. A high proportion (79.5%) of patients with sABI suffered from PUs, being older and more frequently men, with a longer ICU stay between the event and admission to IRU, and a greater MUST score. At discharge, when compared to patients whose PUs had healed, those with persisting PUs were more often men and had the worst cognitive performance at admission. As for nutritional risk, the baseline CONUT score was identified as an independent negative predictor of PUs at discharge by the logistic regression model. In conclusion, the assessment of nutritional risk using simple standard tools may be useful in the clinical evaluation of sABI patients with PUs.
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  • 文章类型: Journal Article
    我们报告了丁香酚作为Bacoblanc分子标记的品种起源的第一个证据,用于生产Armagnac的葡萄品种之一。通过HS-SPME-GC-MS鉴定和定量丁香酚。对于两个单独的年份,从Bacoblanc制成的单一品种葡萄酒烈酒中发现的浓度,were,平均而言,比其他葡萄品种高10倍,范围从31.0到174.7µg/L。进行了研究以量化用于蒸馏的葡萄酒中的丁香酚,在必须,最后在植物的几个部分。对于两个年份的所有矩阵,已证实,丁香酚在Bacoblanc中比在Ugniblanc和Folleblanc中更丰富。此外,酶水解使得从前体中释放大量丁香酚成为可能,证明超过90%的丁香酚结合在必须和葡萄浆果果肉中。
    We report on the first evidence of a varietal origin of eugenol as a molecular marker in Baco blanc, one of the grape varieties used to produce Armagnac. Eugenol was identified and quantified by HS-SPME-GC-MS. For two separate vintages, the concentrations found in monovarietal wine spirits made from Baco blanc, were, on average, 10 times higher than those in other Vitis varieties, ranging from 31.0 to 174.7 µg/L. Investigations were carried out to quantify eugenol in the wines used for distillation, in the musts and finally in several parts of the plant. For all matrices over both vintages, it was confirmed that eugenol is much more abundant in Baco blanc than in Ugni blanc and Folle blanche. Moreover, enzymatic hydrolysis made it possible to release a significant quantity of eugenol from precursors, demonstrating that more than 90% of eugenol is bound in the must and in the grape berry pulp.
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  • 文章类型: Observational Study
    目的:肿瘤内科住院患者营养不良的风险非常高,与营养不良相关的并发症的存在在它们的演变中是重要的。有必要有足够的工具来诊断营养不良。
    目的:本研究旨在评估癌症住院患者的营养状况,并根据不同的营养诊断工具比较并发症的发生率。
    方法:观察性,纵向,回顾性研究是针对2014年1月至2017年6月期间在肿瘤学服务机构接受营养和药物治疗的149例患者进行的.流行病学,临床,人体测量学,并收集营养数据。使用迷你营养评估(MNA)评估营养状况,营养不良通用筛查工具(MUST),以及全球营养不良领导力倡议(GLIM)标准。
    结果:患者年龄为61.61(15.96)岁。67.8%的患者为男性。大多数患者处于晚期肿瘤阶段(III期(15.3%);IV期(77.1%))。MUST的中位数为2(0-3)(高风险:83(55.7%))。MNA中位数为17(14-20)(不良营养状况:65(43.6%);营养不良风险71(47.7%))。根据GLIM标准,115(77.2%)营养不良,和97(65.1%)有严重的营养不良。根据MNA,观察到死亡率增加(MNA<17:24.6%vs.MNA>17:7.9%;pvalue<0.01)。多变量分析显示,无论疾病阶段和患者年龄,用MNA测量的不良营养状况与死亡率增加相关OR:4.1995%CI(1.41-12.47);p值=0.02。
    结论:住院期间要求进行营养评估的癌症患者营养不良率很高。在肿瘤病理的住院患者中,据观察,通过MNA测量的营养不良是死亡风险因素.
    OBJECTIVE: Medical oncology inpatients are at a very high risk of malnutrition, and the presence of complications associated with malnutrition is significant in their evolution. It is necessary to have adequate tools in the diagnosis of malnutrition.
    OBJECTIVE: This study is aimed to assess the nutritional status of cancer inpatients and compare the incidence of complications based on the nutritional diagnosis with different tools.
    METHODS: An observational, longitudinal, and retrospective study was designed on 149 patients admitted to the Oncology Service who were requested nutritional and medical treatment between January 2014 and June 2017. Epidemiological, clinical, anthropometric, and nutritional data were collected. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), and the Global Leadership Initiative on Malnutrition (GLIM) criteria.
    RESULTS: The age of the patients was 61.61 (15.96) years. 67.8% of the patients were men. Most of the patients were in advanced tumor stages (stage III (15.3%); stage IV (77.1%)). The median of the MUST was 2 (0-3) (High risk: 83 (55.7%)). The median MNA was 17 (14-20) (poor nutritional status: 65 (43.6%); risk of malnutrition 71 (47.7%)). According to the GLIM criteria, 115 (77.2%) had malnutrition, and 97 (65.1%) had severe malnutrition. According to MNA, an increase in mortality was observed (MNA <17: 24.6% vs. MNA >17: 7.9%; pvalue <0.01). Multivariate analysis showed that poor nutritional status measured with MNA is related to an increased probability of mortality regardless of the stage of the disease and the patient\'s age OR: 4.19 95% CI (1.41-12.47); p-value = 0.02.
    CONCLUSIONS: Malnutrition among cancer patients in whom a nutritional assessment is requested during admission is very high. In hospitalized patients with oncological pathology, it was observed that malnutrition measured by MNA acts as a mortality risk factor.
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  • 文章类型: Journal Article
    自2000年代以来,新鲜的蘑菇异味(FMOff)一直出现在葡萄酒中;C8化合物,1-octen-3-1,1-辛烯-3-醇和3-辛醇参与这种特定的污染,然而,他们本身并不能完全解释它的发生。这项工作的目的是通过GC-MS鉴定污染基质中的新FMOff标记,将化合物水平与葡萄酒感官特性相关联,并确定1-羟基辛基-3-酮的感官属性,参与FMOff的新候选人。在实践中,葡萄必须品被人工污染,并发酵以获得受污染的葡萄酒。GC-MS分析受污染的葡萄汁和葡萄酒显示,仅在受污染的葡萄汁中存在1-羟基octan-3-one,而不是在健康的控制下。在受FMOff影响的16种葡萄酒中,1-羟辛烷-3-酮水平与感官分析评分显著相关(r2=0.86).最后,合成了1-羟基辛烷-3-酮,发现在葡萄酒基质中产生新鲜的蘑菇香气。
    The fresh mushrooms off-flavor (FMOff) has been appearing in wines since the 2000 s; the C8 compounds, 1-octen-3-one, 1-octen-3-ol and 3-octanol are involved in this specific taint, yet they alone do not fully explain its occurrence. The objective of this work was to identify by GC-MS new FMOff markers in contaminated matrices, to correlate compound levels with wine sensory characterization and to determine the sensory attributes of 1-hydroxyoctan-3-one, a new candidate involved in FMOff. In practice, grape musts were artificially contaminated with Crustomyces subabruptus, and fermented to obtain tainted wines. GC-MS analysis of contaminated musts and wines revealed the presence of 1-hydroxyoctan-3-one only in contaminated musts, and not in the healthy control. In a selection of 16 wines affected by FMOff, the level of 1-hydroxyoctan-3-one correlated significantly (r2 = 0.86) with sensory analysis scores. Finally, 1-hydroxyoctan-3-one was synthesized and found to generate a fresh mushroom aroma in a wine matrix.
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  • 文章类型: Journal Article
    营养不良在中风患者中很常见,因为它与神经和认知障碍以及临床结局有关。营养筛查是对营养不良风险进行分类的过程(即,营养风险)基于经过验证的工具/程序,需要快速,简单,成本效益高,在临床上可靠。这篇综述的重点是中风患者用于评估营养风险的工具/程序。特别关注他们与患者临床特征和结局的关系。中风患者使用了不同的筛查工具/程序,它们在营养风险方面表现出不同的患病率(康复单位较高),并且在短期和长期与临床结果存在显著关系,如感染,残疾,和死亡率。的确,很少有人尝试比较不同工具/程序的有用性和可靠性。需要更多的证据来确定适当的方法来评估疾病急性和亚急性阶段或康复期间的中风患者的营养风险;评估营养治疗对住院期间或康复病房营养不良风险的影响;并将营养筛查纳入明确的营养护理方案。
    Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to be rapid, simple, cost-effective, and reliable in the clinical setting. This review focuses on the tools/procedures used in stroke patients to assess nutritional risk, with a particular focus on their relationships with patients\' clinical characteristics and outcomes. Different screening tools/procedures have been used in stroke patients, which have shown varying prevalence in terms of nutritional risk (higher in rehabilitation units) and significant relationships with clinical outcomes in the short- and long term, such as infection, disability, and mortality. Indeed, there have been few attempts to compare the usefulness and reliability of the different tools/procedures. More evidence is needed to identify appropriate approaches to assessing nutritional risk among stroke patients in the acute and sub-acute phase of disease or during rehabilitation; to evaluate the impact of nutritional treatment on the risk of malnutrition during hospital stay or rehabilitation unit; and to include nutritional screening in well-defined nutritional care protocols.
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  • 文章类型: Journal Article
    在酒精发酵过程中,产生了大量的二氧化碳(CO2),和CO2流可以从发酵必须剥离芳香物质。发酵过程中的香气损失可能很大,并可能导致葡萄酒质量下降。本研究的重点是新的发酵气体捕获技术。在实验中,在长相思发酵过程中捕获了气体。使用气相色谱法测定发酵气体中单个挥发性化合物的浓度,最高的值是通过乙酸异戊酯实现的,异戊醇和癸酸乙酯。十二烷酸乙酯在所研究的挥发性物质中达到最低值。对于感官评估,定量描述性分析(QDA)比较了用于食品目的的用发酵气体碳酸化水和用商业二氧化碳碳酸化水。根据这项研究的结果,可以得出结论,含有正芳香物质的捕获气体适用于食品工业中碳酸饮料的生产。
    During alcoholic fermentation, a considerable amount of carbon dioxide (CO2) is produced, and the stream of CO2 can strip aromatic substances from the fermenting must. Aroma losses during fermentation can be significant and may lead to a reduction in wine quality. This study is focused on new fermentation gas capture technology. In the experiment, gas was captured during the fermentation of sauvignon blanc must. The concentration of individual volatile compounds in the fermentation gas was determined using gas chromatography, and the highest values were achieved by isoamyl acetate, isoamyl alcohol and ethyl decanoate. Ethyl dodecanoate achieved the lowest values of the investigated volatile substances. For sensory assessment, quantitative descriptive analysis (QDA) compared water carbonated with fermentation gas and water carbonated with commercial carbon dioxide for food purposes. Based on the results of this study, it can be concluded that the captured gas containing positive aromatic substances is suitable for the production of carbonated drinks in the food industry.
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  • 文章类型: Systematic Review
    目标:挪威卫生局已确定有必要协调和规范挪威医院和初级卫生保健机构的营养不良筛查做法,以便沿着患者路径提供营养不良筛查的无缝沟通。我们的目的是对用于识别卫生保健机构营养不良风险的筛查工具的有效性和可靠性进行系统审查。诊断或条件和成人年龄组,作为迈向国家推荐一种筛查工具的第一步。
    方法:对评价有效性的文章进行系统的文献检索,协议,以及营养不良筛查工具的可靠性,截至2020年8月,在以下网站进行:MEDLINE,Embase,APAPsycInfo,Cinahl,Cochrane数据库,WebofScience,认识论,SveMed+,还有Norart.系统评价在PROSPERO(CRD42022300558)中注册。对于每一篇文章的批判性评估,使用了营养与饮食学会的质量标准清单。
    结果:该综述确定了105篇符合纳入和排除标准的文章。最常用的验证工具是迷你营养评估简表(MNA),营养不良通用筛查工具(必须),营养不良筛查工具(MST),和营养风险筛查2002(NRS-2002)。MNA,MST和NRS-2002显示总体中等有效性,必须低有效性。所有四个工具都显示出低一致性。MST和MUST在医疗保健环境和年龄组进行了验证。总的来说,可靠性数据有限。
    结论:筛选工具MST和NRS-2002对成人营养不良的识别显示出中等有效性,其中MST在整个医疗保健环境中得到验证。此外,MNA对于确定65岁或65岁以上的成年人营养不良具有中等有效性。
    The Norwegian Directorate of Health has identified a need to harmonize and standardize the malnutrition screening practice in Norwegian hospitals and primary health care settings, in order to provide a seamless communication of malnutrition screening along the patient pathway. Our aim was to perform a systematic review of the validity and reliability of screening tools used to identify risk of malnutrition across health care settings, diagnoses or conditions and adult age groups, as a first step towards a national recommendation of one screening tool.
    A systematic literature search for articles evaluating validity, agreement, and reliability of malnutrition screening tools, published up to August 2020, was conducted in: MEDLINE, Embase, APA PsycInfo, Cinahl, Cochrane Databases, Web of Science, Epistemonikos, SveMed+, and Norart. The systematic review was registered in PROSPERO (CRD42022300558). For critical appraisal of each included article, the Quality Criteria Checklist by The Academy of Nutrition and Dietetics was used.
    The review identified 105 articles that fulfilled the inclusion and exclusion criteria. The most frequently validated tools were Mini Nutritional Assessment short form (MNA), Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), and Nutritional Risk Screening 2002 (NRS-2002). MNA, MST and NRS-2002 displayed overall moderate validity, and MUST low validity. All four tools displayed low agreement. MST and MUST were validated across health care settings and age groups. In general, data on reliability was limited.
    The screening tools MST and NRS-2002 displayed moderate validity for the identification of malnutrition in adults, of which MST is validated across health care settings. In addition, MNA has moderate validity for the identification of malnutrition in adults 65 years or older.
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