Dual enzyme-assisted extraction of total carotenoids from lemon (citrus limo) peels using xylanase and pectinase

Effects of varying enzyme proportions coupled with different incubation periods on the levels and antioxidant capacity of lemon peels carotenoids obtained through dual-enzyme-assited extraction significantly improved the recovery of total carotenoids in comparison with solvent-only extraction. Increase in incubation time slightly improved the recovery of total carotenoids for 25:75 and 50:50 ratios of xylanase-to-pectinase. Highest total carotenoid content (TC) was noted for the extract obtained from 50:50 xylanase-to-pectinase. Highest total carotenoid content (TC) was noted for the exctract obtained from 50:50 xylanse: pectinase treatment at 90 min incubation yielding 36.16 ug phytofluence equivalent/g lemon peel sample. UV-Visible absorption spectra showed consistently the presence of a major peak at around 330 nm similar to that of phytofluence but a small shoulder was observed at around 290 nm at certain conditions (i.e. certain ratio and incubation time) worthy of further investigations. Considering antioxidant activity of the carotenoid extracts, shorter incubation time gave the highest scavenging activity, though low TC. The use of 75:25 xylanase:pectinase ratio and incubation period of 30 min gave statistically comparable TC (35.84 ug/g) with that of 50:50 xylanae:petinase at 90 min (36.16 ug/g) while the antioxidant activity acity radical scavenging tended to be higher at the shorter incubation time. Fourier-Transform Infrared (FTIR) spectra confirmed the presence of hyroxyl-containg carotenoids as well as aromatic ring containing ones, indicating that majority of the recovered carotenoids from lemon peels using enzyme-assisted protocols were oxocarotenoids in nature

The Physician-as-Stakeholder: An Exploratory Qualitative Analysis of Physicians\u27 Motivations for Using Shared Decision Making in the Emergency Department

BACKGROUND: Shared decision making (SDM) is increasingly recognized as an important facet of patient-centered care. Despite growing interest in SDM in the emergency department (ED), little is known about emergency physicians\u27 (EPs\u27) motivations for using SDM. Understanding current patterns of SDM use and EP\u27s rationale for using SDM is essential for the development of interventions to increase use. OBJECTIVES: Recognizing the EP as an important stakeholder in SDM research, we sought to identify and explore factors that may motivate EPs\u27 engagement in SDM. METHODS: In this qualitative study, informed by the Theory of Planned Behavior and Social Cognitive Theory, we conducted semistructured interviews with a purposeful sample of EPs. Interviews were recorded and transcribed verbatim. Using a directed qualitative content analysis approach, three members of the research team performed open coding of the transcripts in an iterative process, building a provisional code book as coding progressed. Respondent validation was employed to ensure methodologic rigor. RESULTS: Fifteen EPs, ages 31-65, from both academic and community practice settings, were interviewed. Several had not heard of the specific phrase shared decision making, but all understood the concept and felt that they used SDM techniques to some degree. Most noted they had often had an agenda when they used SDM, which often motivated them to have the conversation. Agendas described included counteracting an algorithmic or defensive approach to diagnosis and treatment, avoiding harmful tests, or sharing uncertainty. All participants believed that patients benefited from SDM in terms of satisfaction, engagement, or education. Nearly all participants identified research outcomes that they felt would encourage their use of SDM (e.g., improvements in patient engagement, mitigation of risk) and many prioritized patient-centered outcomes over systems outcomes such as improved resource utilization. Little consensus was seen, however, regarding the importance of individual outcomes: of eight potential research outcomes participants endorsed, no single outcome was endorsed by even half of the physicians interviewed. CONCLUSION: Emergency physicians identified many factors that motivated them to use SDM. This study informs current research on SDM in the ED, particularly regarding the motivations of the physician-as-stakeholder