Structural modification of gluten proteins in strong and weak wheat dough as affected by mixing temperature

The effects of temperature ( 6525\ub0C) on dough rheological properties and gluten functionality have been investigated for decades, but no study has addressed the effect of low temperature (<30\ub0C) on gluten network attributes in flours with strong and weak dough characteristics. This study monitored changes in protein extractability in the presence and absence of reducing agents, the contents of readily accessible and SDS-accessible thiols, and the secondary structural features of proteins in doughs from commercial hard wheat flour (HWF) and soft wheat flour (SWF) mixed at 4, 15, and 30\ub0C. SWF mixed at 4 and 15\ub0C showed similar mixing properties as HWF mixed at 30\ub0C (which is the standard temperature). The effect of mixing temperature is different at the molecular level between the two flours studied. Protein features of HWF did not change as mixing temperature decreased, with the only exception being an increase in SDS-accessible thiols. Decreasing mixing temperature for SWF caused an increase in SDS protein solubility and SDS-accessible thiols as well as an increase in \u3b2-turn structures at the expense of \u3b2-sheet structures. Thus, noncovalent interactions appear to drive protein network at low temperatures (4 and 15\ub0C), whereas covalent interactions dominate at standard mixing temperature (30\ub0C) in doughs from both flours

Middlesex University’s Invisque visual analytics tool: supported by text analytics techniques from the University of Leeds

This report describes the joint entry from Middlesex University and the University of Leeds for Mini Challenge 3 for the VAST Challenge 2011. In order to address the challenge question, the primary tool we used was Middlesex University’s Interactive Visual Search and Query Environment (INVISQUE), which served as the user interface to the Mini-Challenge 3 news corpus. INVISQUE was supported by corpus text analytics from the University of Leeds, which provided additional information that was visualised on the INVISQUE user interface

NON-PHARMACEUTICAL TREATMENT OF DEPRESSION USING A MULTIMODAL APPROACH

One hundred forty-one individuals suffering from chronic depression, unresponsive to previous drug therapy, were treated with a 44-hour program of education, Cranial Electrical Stimulation (CES), Brain Wave Synchronization (BWS), musical conditioning, and a mentally programmed quartz or glass "crystal" randomly assigned with therapists and patients blinded to the crystal's composition. Eighty· four percent of the depressed patients were improved at the end of two weeks of therapy, apparently as a result of the multimodal therapy and group interaction. The results at three months follow-up suggest a positive subtle energy effect of quartz: 70% of the depressed patients who received quartz remained improved, while only 31.5% of the depressed patients receiving glass remained improved. These differences are highly statistically significant. It appears that mentally "programmed" quartz may offer a significant reinforcement to allow patients better long-term recovery than would occur with placebo (glass). The cost effectiveness of such a therapeutic approach is significant. Other therapists are encouraged to replicate these studies

The Effect of Pre-existing Seizure Disorders on Mortality and Hospital Length of Stay Following Burn Injury

Patients with a seizure disorder have a higher incidence of burn injury; however, there are limited studies that examine the association between pre-existing seizure disorders (PSD) and burn outcomes. This is a retrospective study of admitted burn patients. Variables analyzed include patient demographics, clinical characteristics, associated PSD, hospital length of stay (LOS), and mortality. Multivariate logistic regression was performed to analyze the impact of PSD on burn mortality and LOS. Seven thousand six hundred and forty patients met the inclusion criteria and 1.31% (n = 100) patients had a PSD. There was no difference in mortality rate between patients with or without PSD (odds ratio [OR] = 2.28, 95% confidence interval [CI] = 0.87 to 5.93). Multivariate logistic regression showed that patients with PSD had significantly increased odds of longer hospital LOS (OR = 2.85, 95% CI = 1.73 to 4.67). Seizure disorder management is mandatory in reducing burn injury and decreasing the costs associated with increased hospital LOS

The epidemiologic characteristics and outcomes following intentional burn injury at a regional burn center

Introduction: Intentional burn injury outcomes are usually more severe, have a high mortality and are seen more often in low and middle-income countries. This study will examine the epidemiological characteristics of intentional burn injury patients and mortality outcomes at a regional Burn Center. Methods: This is a retrospective study of 11,977 patients admitted to a regional Burn center from 2002 to 2015.Variables analyzed were basic demographics (sex, age, and race), total body surface area of burn (%TBSA), presence of inhalation injury, Charlson comorbidity index, intent of injury, mortality, and hospital and ICU length of stay (LOS). Chi-square tests, bivariate analysis and logistic regression models were utilized to determine the effect of burn intent on outcomes. Results: Eleven thousand eight hundred and twenty-three (n = 11,823) adult and pediatric patients from 2002 to 2015 were included in the study. Three hundred and forty-eight (n = 348, 2.9%) patients had intentional burn injuries (IBI). Patients with IBI were younger, 26.5 ± 20 years compared to the non-intentional burn injury (NIBI) group (32 ± 22 years, p < 0.001). Mean %TBSA was significantly higher in the IBI vs. NIBI group at 14.6 ± 20 vs. 6.4 ± 10%, p < 0.001, respectively. Overall, Non-whites (n = 230, 66%) were more likely to have IBI, p < 0.001. Inhalation injury and mortality were statistically significant in the IBI group compared to the NIBI group, (n = 54,16%) vs. (n = 30, 9%) and (n = 649,6%) vs. (n = 329,2.9%), p < 0.001, respectively. Multivariate logistic regression did not show any significant increase in odds of mortality based on burn intent. In subgroup analysis of self-inflicted (SIB) vs. assault burns, SIB patients were significantly older, 38 years (±14.7) vs. 22.4 years (±20.5), p < 0.001 and had a higher %TBSA, 26.5 (±29.6) vs. 10.3 (±13.6), p < 0.001. Seventy three percent (n = 187, 73%) of assault burn patients were Nonwhite and Whites were more likely to incur self-inflicted burns, (n = 53% p < 0.001). Conclusion: We show that patients with intentional burn injuries have an associated increased %TBSA and inhalation injury without increased adjusted odds for mortality. Intentional burns increase health care expenditures. Violence prevention initiatives and access to mental health providers may be beneficial in reducing intentional burn injury burden

Predictors of withdrawal of life support after burn injury

Introduction: Discussions regarding withdrawal of life support after burn injury are challenging and complex. Often, providers may facilitate this discussion when the extent of injury makes survival highly unlikely or when the patient's condition deteriorates during resuscitation. Few papers have evaluated withdrawal of life support in burn patients. We therefore sought to determine the predictor of withdrawal of life support (WLS) in a regional burn center. Methods: We conducted a retrospective analysis of all burn patients from 2002 to 2012. Patient characteristics included age, gender, burn mechanism, percentage total body surface area (%TBSA) burned, presence of inhalation injury, hospital length of stay, and pre-existing comorbidities. Patients <17 years of age and patients with unknown disposition were excluded. Patients were categorized into three cohorts: Alive till discharge (Alive), death by withdrawal of life support (WLS), or death despite ongoing life support (DLS). DLS patients were then excluded from the study population. Multivariate logistic regression was used to estimate predictors of WLS. Results: 8,371 patients were included for analysis: 8134 Alive, 237 WLS. Females had an increased odd of WLS compared to males (OR 2.03, 95% CI 1.18–3.48; p = 0.010). Based on higher CCI, patients with pre-existing comorbidities had an increased odd of WLS (OR 1.28, 95% CI 1.08–1.52; p = 0.005). There was a significantly increased odds for WLS (OR 1.09, 95% CI 1.06–1.12; p < 0.001) with increasing age. Similarly, there was an increased odd for WLS (OR 1.08, 95% CI 1.07–1.51; p < 0.001) with increasing %TBSA. An increased odd of WLS (OR 2.47, 95% CI 1.05–5.78; p = 0.038) was also found in patients with inhalation injury. Conclusion: The decision to withdraw life support is a complex and difficult decision. Our current understanding of predictors of withdrawal of life support suggests that they mirror those factors which increase a patient's risk of mortality. Further research is needed to fully explore end-of-life decision making in regards to burn patients. The role of patient's sex, particularly women, in WLS decision making needs to be further explored

Incidence of self-inflicted burn injury in patients with Major Psychiatric Illness

Introduction: Psychiatric disorders are mental illnesses that impair judgment, thought process and mood that can result in physical and emotional disability. According to DSM-IV, mental disorders increases risk of traumatic injury, particularly burn [1] (American Psychiatric Association, 2013). However, there are few studies that look at patients with pre-existing major psychiatric disorders and burn outcomes. We aim to assess the incidence and intentionality of burn injury in patients with pre-existing psychiatric disorders. Methods: This is a retrospective study of patients admitted to the UNC Jaycee Burn Center from 2002 to 2015 and entered in the burn registry. Variables analyzed include basic demographics, insurance status, total body surface area (TBSA) of burn, Charlson comorbidity index (CCI), burn etiology, presence of inhalation injury, burn circumstance, intensive care unit (ICU) and hospital length of stay (LOS) and mortality. Chi-square, Analysis of Variance (ANOVA), Kruskal–Wallis test and Multivariate logistic regression was used to analyze the data. Results: 11,650 adult and pediatric patients were entered in the burn registry from 2002 to 2015 and 494 (4.2%) adult and pediatric patients had preexisting major psychiatric illness (MPI). Within the large cohort of admitted burn patients, 90 (0.8%) patients presented with self-inflicted burn injuries. 41% of patients with SIB (n = 37/90) had MPI. The incidence of self-inflicted burn injury (SIB) within the MPI (n = 494) cohort was 7.5% (n = 37). Mean age of patients with and without self-inflicted burn injury was 35.3 (±11.6) vs. 41.8 (±17.3), respectively. Mean TBSA was significantly higher in patient with SIB at 18.6 (±16.5) vs. 8.5(±12.2) p < 0.001. Non-white race had significantly higher rate of SIB compared to white cohort. There was no significant difference in mortality rates between SIB and Non-SIB (5.4% vs. 3.7%, p = 0.609), respectively. Median Hospital LOS was significantly increased in patients with SIB compared to NSIB 31 (IQR = 55) vs. 9 (IQR = 20) days, p = 0.004. Multivariate logistic regression for predictors of self-inflicted burn injury showed that minorities were more likely to incur self-inflicted burn injury among patients with major psychiatric illnesses. Conclusion: The incidence of self-induced burn injury in patients with MPI is low and of all the self-inflicted burn patients, 60% did not have a major psychiatric illness identified. Our findings emphasize the importance of identifying patients with MPI with or without self-induced injury that may benefit from more extensive psychiatric screening after burn and counseling, particularly minority patients as they may benefit from additional mental health counseling following severe burn

Racial and ethnic disparities in discharge to rehabilitation following burn injury

Racial and ethnic disparities in access to inpatient rehabilitation have been previously described for various injury groups; however, no studies have evaluated whether such disparities exist among burn patients. Their aim was to determine if racial disparities in discharge destination (inpatient rehabilitation, skilled nursing facility, home with home health, or home) following burn injury existed in this single-institution study. A retrospective analysis of all adult burn patients admitted to UNC Jaycee Burn Center from 2002 to 2012 was conducted. Patient characteristics included age, gender, burn mechanism, insurance status, percentage total body surface area (%TBSA) burned, presence of inhalation injury, and hospital length of stay. Patients were categorized into one of three mutually exclusive racial or ethnic groups: White, Hispanic, or Black. Propensity score weighting followed by ordered logistic regression was performed in the analytical sample and in a subgroup analysis of patients with severe burns (TBSA > 20%). For analysis, 4198 patients were included: 2661 White, 340 Hispanic, and 1197 Black. Propensity weighting resulted in covariate balance among racial groups. Black patients (OR: 1.58, 95% CI: 1.23-2.03; P <.001) were more likely than Whites to be discharged to a higher level of rehabilitation, whereas Hispanics were less likely (OR: 0.78, 95% CI: 0.38-1.58; P =.448). In their subgroup analysis, Black (OR: 1.88, 95% CI: 1.07-3.28; P =.026) and Hispanic (OR: 1.53, 95% CI: 0.31-7.51; P =.603) patients were more likely to discharge to a higher level of rehabilitation than White patients. Racial and ethnic disparities in discharge destination to a higher level of rehabilitative services among burn-injured patients exist particularly for Hispanic patients but not for Black or White burn patient groups. Further studies are needed to elucidate the potential sources of these disparities specifically for Hispanic patients