Modelling of the inactivation kinetics of Escherichia coli, Saccharomyces cerevisiae and pectin methylesterase in orange juice treated with ultrasonic-assisted supercritical carbon dioxide

[EN] The combined effect of supercritical carbon dioxide (SC-CO2) and high power ultrasound (HPU) on the inactivation kinetics of Escherichia coli, Saccharomyces cerevisiae and pectin-methyl esterase (PME) in orange juice was studied in order to select models that can predict their inactivation behaviour based on process parameters. Experiments were performed at different temperatures (31-41 degrees C, 225 bar) and pressures (100-350 bar, 36 degrees C). The inactivation rate of E. coli, S. cerevisiae and PME increased with pressure and temperature during SC-CO2 + HPU treatments. The SC-CO2 + HPU inactivation kinetics of E. coli, S. cerevisiae and PME were represented by models that included temperature, pressure and treatment time as variables, based on the Biphasic, the Peleg Type B, and the fractional models, respectively. The HPU-assisted SC-CO2 batch system permits the use of mild process conditions and treatment times that can be even shorter than those of continuous SC-CO2 systems. (C) 2014 Elsevier B.V. All rights reserved.The authors acknowledge the financial support from project CSD2007-00016 (CONSOLIDER-INGENIO 2010) funded by the Spanish Ministry of Economy and Competitiveness (Madrid, Spain) and from project PROMETEO/2010/062 financed by the Generalitat Valenciana (Conselleria d'Educacio, Cultura i Esport, Valencia, Spain). The authors acknowledge the Universitat Politecnica de Valencia for the FPI grant given to Carmen Ortuno Cases and Dr. Emilia Matallana and Dr. Paula Alepuz for the generous gift of S. cerevisiae T73 and E.coli DH1 strains, respectively.Ortuño Cases, C.; Balaban, M.; Benedito Fort, JJ. (2014). Modelling of the inactivation kinetics of Escherichia coli, Saccharomyces cerevisiae and pectin methylesterase in orange juice treated with ultrasonic-assisted supercritical carbon dioxide. Journal of Supercritical Fluids. 90:18-26. https://doi.org/10.1016/j.supflu.2014.03.004S18269

Combined high hydrostatic pressure and carbon dioxide inactivation of pectin methylesterase, polyphenol oxidase and peroxidase in feijoa puree

[EN] A combined treatment of high hydrostatic pressure (HHP) and dense phase carbon dioxide (DPCD) was investigated to inactivate pectin methylesterase (PME), peroxidase (POD) and polyphenol oxidase (PPO) in feijoa (Acca sellowiana) puree. The treatments were HHP (HHP); carbonation and HHP (HHPcarb); carbonation + addition of 8.5 mL CO2/g puree into the headspace of the package and HHP (HHPcarb + CO2). The different samples were treated at 300,450 and 600 MPa, for 5 min. The residual POD and PPO activity decreased in the order HHP>HHPcarb> HHPcarb+ CO2 at all pressures used. Treatments with HHP at 300 MPa increased POD activity to 140%. The residual PME activity of HHPcarb and HHPcarb+ CO2 samples at 600 MPa (45-50%) was significantly (p<0.05) lower than for HHP treatment (65%). The simultaneous application of HHP and DPCD seems to synergistically enhance the inactivation of the enzymes studied, the CO2 concentration being a key process factor. (C) 2013 Elsevier B.V. All rights reserved.The authors acknowledge the financial support from project CSD2007-00016 (CONSOLIDER-INGENIO 2010) funded by the Spanish Ministry of Science and to the Universitat Politecnica de Valencia for the FPI grant given to Carmen Ortuno Cases.Ortuño Cases, C.; Duong, T.; Balaban, M.; Benedito Fort, JJ. (2013). Combined high hydrostatic pressure and carbon dioxide inactivation of pectin methylesterase, polyphenol oxidase and peroxidase in feijoa puree. Journal of Supercritical Fluids. 82:56-62. https://doi.org/10.1016/j.supflu.2013.06.005S56628

Kinetics of flavour and aroma changes in thermally processed cupuaçu (Theobroma grandiflorum) pulp

Changes in `fresh' and `cooked-notes' during thermal treatment of cupuacËu (Theobroma grandi¯orum) pulp were evaluated and modelled. Isothermal experiments in the temperature range of 70±98°C were carried out and a non-linear regression was performed to all data to estimate kinetic parameters. `Fresh' and `cooked-notes' change followed simple ®rst-order (Ea=78±82kJ mol ÿ1, z =30±31°C) and reversible ®rst order (Ea=80±85kJ mol ÿ1) kinetics, respectively. Although `cookednotes' were linearly correlated with `fresh-notes' (R2=0.99), the former was a better indicator for quality degradation. These results are useful to design pasteurisation processes while minimising sensory changes

Caregiver Burden in Chronic Diseases

Duration of human life has been substantially increased in the last fifty years. Survivals of diseases have been prolonged through the advances in medicine. Together with these gratifying consequences, there appeared novel difficulties to cope with. Furthermore developments including globalization, industrialization and transition from rural to urban life occurred during the last century; so family units became smaller and numbers of members on employment in family units increased. As a result numbers of family members to undertake the responsibility of care decreased. As a concept, caregiver burden expresses physical, psychosocial and financial reactions during the course of care providing. Distinct factors including structures of social, cultural and family units and health care systems may affect conditions of care. Caregiver’s age, gender, ethnicity, education, relationship with the patient, attitude towards providing care, financial situation, coping abilities, her own health, beliefs, social support and cultural pattern are the personal factors that are related to perception of caregiver burden. Burden of care giving is geared to differential aspects of care needs. For instance care needs of physically disabled and medical care requiring patients with spinal cord injuries may differ from care needs of chronic psychiatric disorders, demented patients in advanced age of their lives or cancer patients in terminal periods. Strain due to care giving may differ as a result of properties of care demands. It is aimed to review the burden of caregivers in different medical and psychiatric care requiring conditions and to introduce differential aspects of caregiver burden in these different conditions

TASL practice guidance on the clinical assessment and management of patients with nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is a multisystem disease and is significantly associated with obesity, insulin resistance, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. NAFLD has become the most prevalent chronic liver disease in Western countries, and the proportion of NAFLD-related cirrhosis among patients on liver transplantation waiting lists has increased. In light of the accumulated data about NAFLD, and to provide a common approach with multi-disciplines dealing with the subject, it has become necessary to create new guidance for diagnosing and treating NAFLD. This guidance was prepared following an interdisciplinary study under the leadership of the Turkish Association for the Study of the Liver (TASL), Fatty Liver Special Interest Group. This new TASL Guidance is a practical application guide on NAFLD and was prepared to standardize the clinical approach to diagnosing and treating NAFLD patients. This guidance reflects many advances in the field of NAFLD. The proposals in this guidance are meant to aid decision-making in clinical practice. The guidance is primar-ily intended for gastroenterology, endocrinology, metabolism diseases, cardi-ology, internal medicine, pediatric specialists, and family medicine specialists

Dünyada Göçmenlerin Eğitim Alanındaki Sorununa İlişkin Yasal Düzenlemeler

Göç, gelişmiş toplumlara olumlu veya olumsuz etkileri olabilen nüfusların yer değiştirme hareketi olarak tanımlanabilir. Bu nüfus hareketliliğinin çeşitleri ve etkileri değişiklik göstermektedir. Bu değişiklikler ülkelere göre de çeşitlilik gösterebilmektedir. Bu değişiklikler, beraberindeki sorunların çözümlerini ve göçün topluma olan etkilerini ortaya çıkarması açısından önemlidir. Göç alan ülkelerin genel durumlarına bakıldığı zaman ülkelerin kendilerine ait bir göçmen politikası uygulaması, göçmenleri eğitme politikası ve kendi hukuk düzenlerinde düzenlemeler yapılması zorunluluk olarak karşımıza çıkmaktadır. Göçmenlerin sorun olmaktan çıkarılıp onların topluma uyumunun sağlanması, göçmen eğitimindeki temel yolların başında gelmektedir. Eğitim alan insanların, toplumsal kurallara uymaları ve sosyolojik olarak topluma kendilerini adapte etmeleri daha kolaylaşır. Göç insanların ister kendi ülkeleri içerisinde isterse dış ülkelere yapılsın amaç kendi yaşadıkları bölgenin kötü koşullarından kurtularak daha iyi koşullar elde etmek içindir. Göçmenler çoğu zaman karma sebeplerle göç etmiş, insanların yer değiştirmelerine sebep olan durumlar, yaşanılan yer ve zamana göre değişiklik göstermiştir. Ekonomik rahatlık arayışı, çatışma ya da şiddetten uzaklaşma, politik düzensizlikler, siyasi sığınma isteği, mevcut durumlarına göre şartları daha uygun eğitim imkânları gibi çok farklı etkenden sebebiyle kişisel veya toplu göç hareketleri oluşmuştur ve oluşacaktır. Günümüzde ırkçılık kurumsal alanlarda gözle görülmez ancak derinden hissedilir olduğu bir zamana ırkçılığın artık abartılı ve saldırgan bir şekilde kendini gösterdiği zamandan doğru değişmiştir. Oluşabilecek tepkilerden çekinilmesi sebebiyle kurumsal birçok alanda ırkçılığın devam etmesinin önüne geçilmesiyle birlikte hala bu tutumun zihinlerde yer ettiği görülmektedir. Bundan dolayı hem bireysel hem de toplumsal anlamda sivil toplum örgütlerinin rolü bu alanda daha çok hissedilmektedir Dünyadaki göçmen sorununu çözmek için ülkeler, eğitim alanına ait kendi kanunlarında yeni yasal değişiklikler ve düzenlemeler yapmaktadır. Bu yasal düzenlemeler ülke içerisinde dahi değişiklikler göstermektedir. Günümüz dünyasında göç sorununa yönelik “çok kültürlülük anlayışı“ doğrultusunda uygulamalar yapılmaktadır. Çok kültürlülük çalışmaları toplumsal algının değişmesini ve kültürel çeşitliliği sağlamaktadır. Bunun için yapılan eğitim faaliyetleri, ülkelerin ve toplumların da eğitimiyle mümkün olmaktadır. Göçmen sorunlarının çözümüne yönelik daha gelenekçi anlayışlarda ise eğitimi “asimilasyon yoluyla“ yapılan politikalar çözüm yolu gibi görünse de eğitimin hedeflenen olumlu sonuçlarından ziyade olumsuz sonuçlara yol açtığı görülmektedir

Outcome of COVID-19 in Patients With Autoimmune Hepatitis: An International Multicenter Study

Background and Aims: Data regarding outcome of COVID-19 in patients with autoimmune hepatitis (AIH) are lacking. Approach and Results: We performed a retrospective study on patients with AIH and COVID-19 from 34 centers in Europe and the Americas. We analyzed factors associated with severe COVID-19 outcomes, defined as the need for mechanical ventilation, intensive care admission, and/or death. The outcomes of patients with AIH were compared to a propensity score?matched cohort of patients without AIH but with chronic liver diseases (CLD) and COVID-19. The frequency and clinical significance of new-onset liver injury (alanine aminotransferase > 2 × the upper limit of normal) during COVID-19 was also evaluated. We included 110 patients with AIH (80% female) with a median age of 49 (range, 18-85) years at COVID-19 diagnosis. New-onset liver injury was observed in 37.1% (33/89) of the patients. Use of antivirals was associated with liver injury (P = 0.041; OR, 3.36; 95% CI, 1.05-10.78), while continued immunosuppression during COVID-19 was associated with a lower rate of liver injury (P = 0.009; OR, 0.26; 95% CI, 0.09-0.71). The rates of severe COVID-19 (15.5% versus 20.2%, P = 0.231) and all-cause mortality (10% versus 11.5%, P = 0.852) were not different between AIH and non-AIH CLD. Cirrhosis was an independent predictor of severe COVID-19 in patients with AIH (P < 0.001; OR, 17.46; 95% CI, 4.22-72.13). Continuation of immunosuppression or presence of liver injury during COVID-19 was not associated with severe COVID-19. Conclusions: This international, multicenter study reveals that patients with AIH were not at risk for worse outcomes with COVID-19 than other causes of CLD. Cirrhosis was the strongest predictor for severe COVID-19 in patients with AIH. Maintenance of immunosuppression during COVID-19 was not associated with increased risk for severe COVID-19 but did lower the risk for new-onset liver injury during COVID-19.Fil: Efe, Cumali. Harran University Hospital; TurquíaFil: Dhanasekaran, Renumathy. University of Stanford; Estados UnidosFil: Lammert, Craig. University School of Medicine; Estados UnidosFil: Ebik, Berat. Gazi Yaşargil Education and Research Hospital; TurquíaFil: Higuera de la Tijera, Fatima. Hospital General de México; MéxicoFil: Aloman, Costica. Rush University Medical Center; Estados UnidosFil: Rıza Calışkan, Ali. Adıyaman University; TurquíaFil: Peralta, Mirta. Latin American Liver Research Educational And Awareness Network; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; ArgentinaFil: Gerussi, Alessio. University of Milano Bicocca; Italia. San Gerardo Hospital; ItaliaFil: Massoumi, Hatef. Montefiore Medical Center; Estados UnidosFil: Catana, Andreea M.. Harvard Medical School; Estados UnidosFil: Torgutalp, Murat. Universitätsmedizin Berlin; AlemaniaFil: Purnak, Tugrul. McGovern Medical School; Estados UnidosFil: Rigamonti, Cristina. Azienda Ospedaliera Maggiore Della Carita Di Novara; Italia. Università del Piemonte Orientale; ItaliaFil: Gomez Aldana, Andres Jose. Universidad de los Andes; ColombiaFil: Khakoo, Nidah. University of Miami; Estados UnidosFil: Kacmaz, Hüseyin. Adıyaman University; TurquíaFil: Nazal, Leyla. Clínica Las Condes; ChileFil: Frager, Shalom. Montefiore Medical Center; Estados UnidosFil: Demir, Nurhan. Haseki Training and Research Hospita; TurquíaFil: Irak, Kader. SBU Kanuni Sultan Süleyman Training and Research Hospital; TurquíaFil: Ellik, Zeynep Melekoğlu. Ankara University Medical Faculty; TurquíaFil: Balaban, Yasemin. Hacettepe University; TurquíaFil: Atay, Kadri. Mardin State Hospital; TurquíaFil: Eren, Fatih. Ordu State Hospital; TurquíaFil: Cristoferi, Laura. University of Milano Bicocca; Italia. San Gerardo Hospital; ItaliaFil: Batibay, Ersin. Harran University Hospital; TurquíaFil: Urzua, Álvaro. Universidad de Chile. Facultad de Medicina.; ChileFil: Snijders, Romee. Radboud University Medical Center; Países BajosFil: Ridruejo, Ezequiel. Latin American Liver Research Educational and Awareness Network; Argentina. Cerrahpaşa School of Medicine; Turquía. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Effects of immunosuppressive drugs on COVID-19 severity in patients with autoimmune hepatitis

Background: We investigated associations between baseline use of immunosuppressive drugs and severity of Coronavirus Disease 2019 (COVID-19) in autoimmune hepatitis (AIH). Patients and methods: Data of AIH patients with laboratory confirmed COVID-19 were retrospectively collected from 15 countries. The outcomes of AIH patients who were on immunosuppression at the time of COVID-19 were compared to patients who were not on AIH medication. The clinical courses of COVID-19 were classified as (i)-no hospitalization, (ii)-hospitalization without oxygen supplementation, (iii)-hospitalization with oxygen supplementation by nasal cannula or mask, (iv)-intensive care unit (ICU) admission with non-invasive mechanical ventilation, (v)-ICU admission with invasive mechanical ventilation or (vi)-death and analysed using ordinal logistic regression. Results: We included 254 AIH patients (79.5%, female) with a median age of 50 (range, 17-85) years. At the onset of COVID-19, 234 patients (92.1%) were on treatment with glucocorticoids (n = 156), thiopurines (n = 151), mycophenolate mofetil (n = 22) or tacrolimus (n = 16), alone or in combinations. Overall, 94 (37%) patients were hospitalized and 18 (7.1%) patients died. Use of systemic glucocorticoids (adjusted odds ratio [aOR] 4.73, 95% CI 1.12-25.89) and thiopurines (aOR 4.78, 95% CI 1.33-23.50) for AIH was associated with worse COVID-19 severity, after adjusting for age-sex, comorbidities and presence of cirrhosis. Baseline treatment with mycophenolate mofetil (aOR 3.56, 95% CI 0.76-20.56) and tacrolimus (aOR 4.09, 95% CI 0.69-27.00) were also associated with more severe COVID-19 courses in a smaller subset of treated patients. Conclusion: Baseline treatment with systemic glucocorticoids or thiopurines prior to the onset of COVID-19 was significantly associated with COVID-19 severity in patients with AIH.Fil: Efe, Cumali. Harran University Hospita; TurquíaFil: Lammert, Craig. University School of Medicine Indianapolis; Estados UnidosFil: Taşçılar, Koray. Universitat Erlangen-Nuremberg; AlemaniaFil: Dhanasekaran, Renumathy. University of Stanford; Estados UnidosFil: Ebik, Berat. Gazi Yasargil Education And Research Hospital; TurquíaFil: Higuera de la Tijera, Fatima. Hospital General de México; MéxicoFil: Calışkan, Ali R.. No especifíca;Fil: Peralta, Mirta. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; ArgentinaFil: Gerussi, Alessio. Università degli Studi di Milano; ItaliaFil: Massoumi, Hatef. No especifíca;Fil: Catana, Andreea M.. Harvard Medical School; Estados UnidosFil: Purnak, Tugrul. University of Texas; Estados UnidosFil: Rigamonti, Cristina. Università del Piemonte Orientale ; ItaliaFil: Aldana, Andres J. G.. Fundacion Santa Fe de Bogota; ColombiaFil: Khakoo, Nidah. Miami University; Estados UnidosFil: Nazal, Leyla. Clinica Las Condes; ChileFil: Frager, Shalom. Montefiore Medical Center; Estados UnidosFil: Demir, Nurhan. Haseki Training And Research Hospital; TurquíaFil: Irak, Kader. Kanuni Sultan Suleyman Training And Research Hospital; TurquíaFil: Melekoğlu Ellik, Zeynep. Ankara University Medical Faculty; TurquíaFil: Kacmaz, Hüseyin. Adıyaman University; TurquíaFil: Balaban, Yasemin. Hacettepe University; TurquíaFil: Atay, Kadri. No especifíca;Fil: Eren, Fatih. No especifíca;Fil: Alvares da-Silva, Mario R.. Universidade Federal do Rio Grande do Sul; BrasilFil: Cristoferi, Laura. Università degli Studi di Milano; ItaliaFil: Urzua, Álvaro. Universidad de Chile; ChileFil: Eşkazan, Tuğçe. Cerrahpaşa School of Medicine; TurquíaFil: Magro, Bianca. No especifíca;Fil: Snijders, Romee. No especifíca;Fil: Barutçu, Sezgin. No especifíca;Fil: Lytvyak, Ellina. University of Alberta; CanadáFil: Zazueta, Godolfino M.. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Demirezer Bolat, Aylin. Ankara City Hospital; TurquíaFil: Aydın, Mesut. Van Yuzuncu Yil University; TurquíaFil: Amorós Martín, Alexandra Noemí. No especifíca;Fil: De Martin, Eleonora. No especifíca;Fil: Ekin, Nazım. No especifíca;Fil: Yıldırım, Sümeyra. No especifíca;Fil: Yavuz, Ahmet. No especifíca;Fil: Bıyık, Murat. Necmettin Erbakan University; TurquíaFil: Narro, Graciela C.. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Bıyık, Murat. Uludag University; TurquíaFil: Kıyıcı, Murat. No especifíca;Fil: Kahramanoğlu Aksoy, Evrim. No especifíca;Fil: Vincent, Maria. No especifíca;Fil: Carr, Rotonya M.. University of Pennsylvania; Estados UnidosFil: Günşar, Fulya. No especifíca;Fil: Reyes, Eira C.. Hepatology Unit. Hospital Militar Central de México; MéxicoFil: Harputluoğlu, Murat. Inönü University School of Medicine; TurquíaFil: Aloman, Costica. Rush University Medical Center; Estados UnidosFil: Gatselis, Nikolaos K.. University Hospital Of Larissa; GreciaFil: Üstündağ, Yücel. No especifíca;Fil: Brahm, Javier. Clinica Las Condes; ChileFil: Vargas, Nataly C. E.. Hospital Nacional Almanzor Aguinaga Asenjo; PerúFil: Güzelbulut, Fatih. No especifíca;Fil: Garcia, Sandro R.. Hospital Iv Víctor Lazarte Echegaray; PerúFil: Aguirre, Jonathan. Hospital Angeles del Pedregal; MéxicoFil: Anders, Margarita. Hospital Alemán; ArgentinaFil: Ratusnu, Natalia. Hospital Regional de Ushuaia; ArgentinaFil: Hatemi, Ibrahim. No especifíca;Fil: Mendizabal, Manuel. Universidad Austral; ArgentinaFil: Floreani, Annarosa. Università di Padova; ItaliaFil: Fagiuoli, Stefano. No especifíca;Fil: Silva, Marcelo. Universidad Austral; ArgentinaFil: Idilman, Ramazan. No especifíca;Fil: Satapathy, Sanjaya K.. No especifíca;Fil: Silveira, Marina. University of Yale. School of Medicine; Estados UnidosFil: Drenth, Joost P. H.. No especifíca;Fil: Dalekos, George N.. No especifíca;Fil: N.Assis, David. University of Yale. School of Medicine; Estados UnidosFil: Björnsson, Einar. No especifíca;Fil: Boyer, James L.. University of Yale. School of Medicine; Estados UnidosFil: Yoshida, Eric M.. University of British Columbia; CanadáFil: Invernizzi, Pietro. Università degli Studi di Milano; ItaliaFil: Levy, Cynthia. University of Miami; Estados UnidosFil: Montano Loza, Aldo J.. University of Alberta; CanadáFil: Schiano, Thomas D.. No especifíca;Fil: Ridruejo, Ezequiel. Universidad Austral; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Wahlin, Staffan. No especifíca