Analyses of the Leaf, Fruit and Seed of Thaumatococcus tktniellii (Benth.): Exploring Potential Uses

Thaumatococcus daniellii is an economic plant with versatile uses in Southern Nigeria. The arils attached to the seeds contain thawnatin, a non-sugar sweetener and taste modifier. This study examined the chemical constituents of the leaf, fruit and seed ofT. daniellii. The fresh fruit, on weight basis, consists of 4.8% aril, 22.8% seed and 72.4% fleshy part The leaf contained (per 100 g): 10.67 g moisture, 8.95 gash, 17.21 g fat, 21.06 g protein, 24.61 g crude fiber 17.50 g carbohydrate, 0.10 g calcium, 0.08 g magnesium, 0.01 g iron and 0.37 g phosphorus. The fruit (fleshy part) contained 10.04 g moisture, 21.08 gash, 0.93 g fat 11.53 g protein, 18.43 g crude fiber, 37.27 g carbohydrate, 0.34 g calcium, 0.30 g magnesium, 0.01 g iron and 0.21 g phosphorus. The seed contained 15.15 g moisture, 11.30 g ash, 0.21 g fat, 10.36 g protein, 20.52 g crude fiber and 42.46 g carbohydrate. Terpenoids, flavonoids, alkaloids and cardiac glycosoides were significantly present in both the leaf and fruit whereas phlobatani:n, saponin, steroids, anthraquinones and ascorbic acid were absent. Tannin was present only in the leaf. The leaf and fruit ofT. daniellii have significant nutritional and medicinal benefits. The leaf is rich in protein and fat. The fruit is a good source of minerals, particularly, calciwn and magnesiwn; the leaf is also rich in phosphoru

Analyses of the Leaf, Fruit and Seed of Thaumatococcus tktniellii (Benth.): Exploring Potential Uses

Thaumatococcus daniellii is an economic plant with versatile uses in Southern Nigeria. The arils attached to the seeds contain thawnatin, a non-sugar sweetener and taste modifier. This study examined the chemical constituents of the leaf, fruit and seed ofT. daniellii. The fresh fruit, on weight basis, consists of 4.8% aril, 22.8% seed and 72.4% fleshy part The leaf contained (per 100 g): 10.67 g moisture, 8.95 gash, 17.21 g fat, 21.06 g protein, 24.61 g crude fiber 17.50 g carbohydrate, 0.10 g calcium, 0.08 g magnesium, 0.01 g iron and 0.37 g phosphorus. The fruit (fleshy part) contained 10.04 g moisture, 21.08 gash, 0.93 g fat 11.53 g protein, 18.43 g crude fiber, 37.27 g carbohydrate, 0.34 g calcium, 0.30 g magnesium, 0.01 g iron and 0.21 g phosphorus. The seed contained 15.15 g moisture, 11.30 g ash, 0.21 g fat, 10.36 g protein, 20.52 g crude fiber and 42.46 g carbohydrate. Terpenoids, flavonoids, alkaloids and cardiac glycosoides were significantly present in both the leaf and fruit whereas phlobatani:n, saponin, steroids, anthraquinones and ascorbic acid were absent. Tannin was present only in the leaf. The leaf and fruit ofT. daniellii have significant nutritional and medicinal benefits. The leaf is rich in protein and fat. The fruit is a good source of minerals, particularly, calciwn and magnesiwn; the leaf is also rich in phosphoru

Solar-eclipse-induced perturbations at mid-latitude during the 21 August 2017 event

A study of the response of some ionospheric parameters and their relationship in describing the behaviour of ionospheric mechanisms during the solar eclipse of 21 August 2017 is presented. Mid-latitude stations located along the eclipse path and with data available from the Global Ionospheric radio Observatory (GIRO) database were selected. The percentage of obscuration at these stations ranges between 63&thinsp;% and 100&thinsp;%. A decrease in electron density during the eclipse is attributed to a reduction in solar radiation and natural gas heating. The maximum magnitude of the eclipse consistently coincided with a hmF2 increase and with a lagged maximum decrease in NmF2 at the stations investigated. The results revealed that the horizontal neutral wind flow is as a consequence of the changes in the thermospheric and diffusion processes. The unusual increase and decrease in the shape and thickness parameters during the eclipse period relative to the control days points to the perturbation caused by the solar eclipse. The relationships of the bottomside ionosphere and the F2 layer parameters with respect to the scale height are shown in the present work as viable parameters for probing the topside ionosphere during the eclipse. Furthermore, this study shows that in addition to traditional ways of analysing the thermospheric composition and neutral wind flow, proper relation of standardized NmF2 and hmF2 can be conveniently used to describe the mechanisms.</p

Mild Traumatic Brain Injury in UK Military Personnel Returning From Afghanistan and Iraq

Objectives: To assess (a) the prevalence of mild traumatic brain injury (mTBI) in UK military personnel deployed to Iraq and/or Afghanistan, (b) the risk factors associated with mTBI, and (c) the association between mTBI and subsequent postconcussion symptoms (PCS). Participants: A total of 4620 personnel deployed to Iraq and/or Afghanistan who completed a questionnaire between 2007 and 2009, of whom 2333 were also studied in 2005, participated in the study. Main Outcome Measures: Mild traumatic brain injury during deployment, as identified using a modified version of the Brief Traumatic Brain Injury Screen questionnaire; symptoms associated with PCS in the month before questionnaire completion. Results: The prevalence of mTBI was 4.4%, and the prevalence in those with a combat role was 9.5%. Having an mTBI was associated with current symptoms of posttraumatic stress disorder (adjusted odds ratio (AOR), 5.2; 95% confidence interval [CI], 2.3-11.4), alcohol misuse (AOR, 2.3; 95% CI, 1.4-3.7), and multiple physical symptoms (AOR, 2.6; 95% CI, 1.3-5.2). Only 3 of 9 symptoms remained associated with mTBI after adjustment. Psychological distress and alcohol misuse recorded before deployment were associated with subsequent mTBI. Conclusions: The prevalence of mTBI in UK military is lower than that in the US military. Symptoms of current posttraumatic stress disorder and alcohol misuse are associated with mTBI. Symptoms of mental disorder predated occurrence of mTBI. The majority PCS were not associated with mTBI

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population