Danish study of Non-Invasive testing in Coronary Artery Disease 2 (Dan-NICAD 2): study design for a controlled study of diagnostic accuracy

Background: Coronary computed tomography angiography (CTA) is the preferred primary diagnostic modality when examining patients with low to intermediate pre-test probability of coronary artery disease (CAD). Only 20-30% of these have potentially obstructive CAD. Because of the relatively poor positive predictive value of coronary CTA, unnecessary invasive coronary angiographies (ICA) are conducted with the costs and risks associated with the procedure. Hence, an optimized diagnostic CAD algorithm may reduce the numbers of ICAs not followed by revascularization. The Dan-NICAD 2 study has three equivalent main aims: 1) to examine the diagnostic precision of a sound based diagnostic algorithm, The CADScor®System (Acarix A/S, Denmark), in patients with a low to intermediate pre-test risk of CAD referred to a primary examination by coronary CTA. We hypothesize that the CADScor®System provides better stratification prior to coronary CTA than clinical risk stratification scores alone. 2) to compare the diagnostic accuracy of 3 Tesla cardiac magnetic resonance imaging (3T CMRI), 82Rubidium positron emission tomography (82Rb-PET) and CT-derived fractional flow reserve (FFRCT) in patients where obstructive CAD cannot be ruled out by coronary CTA using ICA fractional flow reserve (FFR) as reference standard. 3) to compare the diagnostic performance of quantitative flow ratio (QFR) and ICA-FFR in patients with low to intermediate pre-test probability of CAD using 82Rb-PET as reference standard. Methods/design: Dan-NICAD 2 is a prospective, multicenter, cross-sectional study including approximately 2,000 patients with low to intermediate pre-test probability of CAD and without previous history of CAD. Patients are referred to CTA because of symptoms suggestive of CAD, as evaluated by a cardiologist. Patient interviews, sound recordings, and blood samples are obtained in connection with the coronary CTA. If coronary CTA does not rule-out obstructive CAD, patients will be examined by both 3T CMRI, 82Rb-PET, FFRCT, ICA and FFR. Reference standard is ICA-FFR. Obstructive CAD is defined as an FFR ≤0.80 or as high-grade stenosis (>90 % diameter stenosis) by visual assessment. Diagnostic performance will be evaluated as sensitivity, specificity, predictive values, likelihood ratios, calibration, and discrimination. Enrolment started January 2018 and is expected to be completed by June 2020. Patients are followed for 10 years after inclusion. Discussion: The results of the Dan-NICAD 2 study are expected to contribute to the improvement of diagnostic strategies for patients suspected of CAD in three different steps; risk-stratification prior to coronary CTA, diagnostic strategy after coronary CTA and invasive wireless QFR analysis as an alternative to ICA-FFR. Study registration: Clinicaltrials.gov identifier, NCT03481712. Registered on January 25th 2018.Aarhus UniversityHealth Research Fund of Central Denmark RegionAcarix A/

Sunflower wax recovered from oil tank settlings: Revaluation of a waste product from the oilseed industry

BACKGROUND: The sunflower oil industry produces a large amount of waste that is not currently commercially exploited, as in the case of oil‐tank settlings. The recovery of a high value‐added by‐product, such as sunflower wax, would increase the commercial value of this waste. In this original research paper, a method that allows the recovery and purification of this by‐product was developed. The wax was characterized and its potential use as an organogelator agent was investigated. RESULTS: The waste sample was composed of 45.1% oily material, 16.9% of this being impure waxes. Purification was performed through two different methods, obtaining three waxes with different degrees of purity. All the waxes were composed of wax esters with a range of 40–60 carbon atoms, exhibiting traces of carotenes, free fatty acids, and free fatty alcohols. The presence of phospholipids was observed in two of them. The third wax presented a higher total wax ester content and physicochemical characteristics (color and thermal behavior) similar to those of commercial sunflower waxes, and was the most efficient organogelator agent, requiring only a small amount of wax (1.5%) to structure high oleic sunflower oil. CONCLUSION: It was verified that sunflower wax could be recovered from oil‐tank settlings. A purification method that allowed sunflower wax with similar physicochemical properties to those of commercial waxes to be obtained was also developed. The purified waxes were capable of structuring high oleic sunflower oil. © 2019 Society of Chemical IndustryFil: Redondas, Cintia Elizabeth. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Química; ArgentinaFil: Baumler, Erica Raquel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Química; ArgentinaFil: Carelli Albarracin, Amalia Antonia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Química; Argentin

Preparation and characterization of oleogel emulsions: A comparative study between the use of recovered and commercial sunflower waxes as structuring agent

The objective of this study was to evaluate the capacity of recovered sunflower waxes (RW) to be used as a structuring agent of oleogel emulsions in comparison with commercial sunflower waxes (CW). RW were recovered from filter cake with a simple hexane extraction procedure. For this purpose, oleogel-based emulsions were prepared using 2%, 3.5%, and 5% w/w wax in oleogel and characterized using several physicochemical techniques in order to evaluate the potential of these materials to develop products with functionality similar to commercial margarines. The total wax esters content of RW was similar to that of the CW and was mainly composed of wax esters with more than 44 carbon atoms (crystallizable waxes). Polarized light and scanning electron microscopy showed that RW produced emulsions with more intricate crystalline networks composed of smaller platelets than CW. The melting enthalpy was greater in CW emulsions than RW emulsions, which was in agreement with the thermal behavior found for CW and RW. The oil binding capacity of CW oleogel emulsions was higher than the RW ones, and this property improved with the increase in wax concentration. Likewise, the elastic behavior, as well as hardness and adhesiveness, increased with the wax content as a result of a greater amount of microstructural elements composing the network of these semisolid materials. The oleogel emulsions stability was monitored for 2 months at room temperature. The increase of CW concentration slowed down the coalescence process, but this behavior was not observed for RW emulsions. Obtained results demonstrated that RW oleogel emulsions have the potential to replace the functionality of soft spreadable products. Practical Application: Wax esters are organogelators that have been shown to successfully gel liquid oil at low concentrations. In this work, we are interested in evaluating the potential of sunflower waxes recovered from filter cake, a waste generated during refined oil production, to structure oil and produce oil-in-water emulsions with functionality similar to commercial margarines. With this, it is sought not only the development of healthier fats but also the use of wastes to generate more sustainable products.Fil: Merchan Sandoval, Julie Pauline. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Química; ArgentinaFil: Carelli Albarracin, Amalia Antonia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Química; ArgentinaFil: Palla, Camila Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Química; ArgentinaFil: Baumler, Erica Raquel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Química; Argentin