Progressive freeze concentration of skim milk in an agitated vessel: effect of the coolant temperature and stirring rate on the process performance

The aim of this study was to investigate the freeze-concentration of skimmed milk by a progressive freeze concentration process. The progressive freeze concentration procedure was performed at three different temperatures (5, 10, and 15 C) and stirring rates (0, 500, and 1000 r/min).Postprint (published version

Distribución de competencias tributarias y financiación local en América Latina: un análisis comparado

El presente Documento de Trabajo recoge los artículos seleccionados en el marco del Call for Papers sobre Fiscalidad en América Latina que convoco el Instituto de Estudios Latinoamericanos de la Universidad de Alcalá. Este número presenta los artículos relativos a la temática económicaLos procesos de descentralización llevados a cabo en muchos países de América Latina han provocado el traspaso de un gran número de competencias desde la Administración Central a otras de ámbito inferior y, en particular, hacia los Gobiernos locales. Esta asunción de competencias por parte de las entidades subcentrales de gobierno implica la necesidad de recursos para alcanzar un grado suficiente de autonomía financiera por lo que el diseño de los modelos de financiación local resulta esencial. En el presente trabajo se han analizado los sistemas de financiación de las Haciendas Locales de algunos países representativos de América Latina como Brasil, Argentina, Chile, El Salvador y Perú. Para ello se han tenido en cuenta los modelos de distribución de competencias, los regímenes tributarios locales y los sistemas de transferencias como mecanismos de financiación intergubernamentalesThe decentralization processes carried out in many countries of Latin America have caused the transfer of different tax competencies from Central Government to lower levels and, in particular, to Local Governments. This assumption of tax competencies by Sub central levels of Governments implies the need of resources to achieve an adequate degree of financial self‐government. Thereby, the design of Local funding models is essential. In this paper, we have analyzed the Local funding models in some representative countries of Latin America such as Brazil, Argentina, Chile, El Salvador and Peru. Bearing this in mind, we have taken into account the patterns of tax competencies, the Local tax models and the grants systems as intergovernmental funding mechanism

Distribución de competencias tributarias y financiación local en América Latina: un análisis comparado

El presente Documento de Trabajo recoge los artículos seleccionados en el marco del Call for Papers sobre Fiscalidad en América Latina que convoco el Instituto de Estudios Latinoamericanos de la Universidad de Alcalá. Este número presenta los artículos relativos a la temática económicaLos procesos de descentralización llevados a cabo en muchos países de América Latina han provocado el traspaso de un gran número de competencias desde la Administración Central a otras de ámbito inferior y, en particular, hacia los Gobiernos locales. Esta asunción de competencias por parte de las entidades subcentrales de gobierno implica la necesidad de recursos para alcanzar un grado suficiente de autonomía financiera por lo que el diseño de los modelos de financiación local resulta esencial. En el presente trabajo se han analizado los sistemas de financiación de las Haciendas Locales de algunos países representativos de América Latina como Brasil, Argentina, Chile, El Salvador y Perú. Para ello se han tenido en cuenta los modelos de distribución de competencias, los regímenes tributarios locales y los sistemas de transferencias como mecanismos de financiación intergubernamentalesThe decentralization processes carried out in many countries of Latin America have caused the transfer of different tax competencies from Central Government to lower levels and, in particular, to Local Governments. This assumption of tax competencies by Sub central levels of Governments implies the need of resources to achieve an adequate degree of financial self‐government. Thereby, the design of Local funding models is essential. In this paper, we have analyzed the Local funding models in some representative countries of Latin America such as Brazil, Argentina, Chile, El Salvador and Peru. Bearing this in mind, we have taken into account the patterns of tax competencies, the Local tax models and the grants systems as intergovernmental funding mechanism

Procalcitonin and lung ultrasonography point-of-care testing to decide on antibiotic prescription in patients with lower respiratory tract infection in primary care: protocol of a pragmatic cluster randomized trial

A minority of patients presenting with lower respiratory tract infection (LRTI) to their general practitioner (GP) have community-acquired pneumonia (CAP) and require antibiotic therapy. Identifying them is challenging, because of overlapping symptomatology and low diagnostic performance of chest X-ray. Procalcitonin (PCT) can be safely used to decide on antibiotic prescription in patients with LRTI. Lung ultrasound (LUS) is effective in detecting lung consolidation in pneumonia and might compensate for the lack of specificity of PCT. We hypothesize that combining PCT and LUS, available as point-of care tests (POCT), might reduce antibiotic prescription in LRTIs without impacting patient safety in the primary care setting. This is a three-arm pragmatic cluster randomized controlled clinical trial. GPs are randomized either to PCT and LUS-guided antibiotic therapy or to PCT only-guided therapy or to usual care. Consecutive adult patients with an acute cough due to a respiratory infection will be screened and included if they present a clinical pneumonia as defined by European guidelines. Exclusion criteria are previous antibiotics for the current episode, working diagnosis of sinusitis, severe underlying lung disease, severe immunosuppression, hospital admission, pregnancy, inability to provide informed consent and unavailability of the GP. Patients will fill in a 28 day-symptom diary and will be contacted by phone on days 7 and 28. The primary outcome is the proportion of patients prescribed any antibiotic up to day 28. Secondary outcomes include clinical failure by day 7 (death, admission to hospital, absence of amelioration or worsening of relevant symptoms) and by day 28, duration of restricted daily activities, episode duration as defined by symptom score, number of medical visits, number of days with side effects due to antibiotics and a composite outcome combining death, admission to hospital and complications due to LRTI by day 28. An evaluation of the cost-effectiveness and of processes in the clinic using a mixed qualitative and quantitative approach will also be conducted. Our intervention targets only patients with clinically suspected CAP who have a higher pretest probability of definite pneumonia. The intervention will not substitute clinical assessment but completes it by introducing new easy-to-perform tests. The study was registered on the 19th of June 2017 on the clinicaltrials.gov registry using reference number; NCT03191071

European Ultrahigh-Field Imaging Network for Neurodegenerative Diseases (EUFIND).

INTRODUCTION: The goal of European Ultrahigh-Field Imaging Network in Neurodegenerative Diseases (EUFIND) is to identify opportunities and challenges of 7 Tesla (7T) MRI for clinical and research applications in neurodegeneration. EUFIND comprises 22 European and one US site, including over 50 MRI and dementia experts as well as neuroscientists. METHODS: EUFIND combined consensus workshops and data sharing for multisite analysis, focusing on 7 core topics: clinical applications/clinical research, highest resolution anatomy, functional imaging, vascular systems/vascular pathology, iron mapping and neuropathology detection, spectroscopy, and quality assurance. Across these topics, EUFIND considered standard operating procedures, safety, and multivendor harmonization. RESULTS: The clinical and research opportunities and challenges of 7T MRI in each subtopic are set out as a roadmap. Specific MRI sequences for each subtopic were implemented in a pilot study presented in this report. Results show that a large multisite 7T imaging network with highly advanced and harmonized imaging sequences is feasible and may enable future multicentre ultrahigh-field MRI studies and clinical trials. DISCUSSION: The EUFIND network can be a major driver for advancing clinical neuroimaging research using 7T and for identifying use-cases for clinical applications in neurodegeneration

Aspectos clínicos da dengue em crianças e perspectivas quanto às vacinas no Brasil

O presente artigo teve como objetivo abordar a ocorrência da dengue na infância, descrevendo desde sua etiologia até o tratamento, bem como as perspectivas atuais sobre vacinas existentes e sua eficácia. Sabe-se que a dengue é uma doença de significativa importância no cenário socioeconômico e de saúde pública mundial e as crianças constituem um grupo vulnerável às formas graves. A doença apresenta-se de diversas formas, desde assintomática, oligossintomática, dengue clássica, febre hemorrágica da dengue até síndrome do choque. Assim, o diagnóstico precoce e o manejo adequado previnem fatalidades. Até o momento, não há terapia antiviral específica para a dengue e o tratamento é limitado aos cuidados de suporte, sendo o principal meio de prevenção a vigilância e o controle vetorial. Outra estratégia disponível recentemente para a prevenção é a vacina contra a dengue. Entretanto, encontrar evidências quanto à eficácia das vacinas em crianças é um grande desafio, devido a heterogeneidade de abordagem e as diferenças entre estudos. Ainda assim, as pesquisas têm mostrado que as vacinas promovem redução nas taxas de hospitalização e gravidade da doença, o que reforça a necessidade de mais estudos e análises acerca desse tema

Imunoterapia como alternativa terapêutica para rinite alérgica em paciente pediátrico

O presente artigo teve como objetivo discutir, a partir de uma revisão narrativa da literatura, as principais características do desenvolvimento na rinite alérgica na população pediátrica, destacando a imunoterapia como uma das formas de tratamento farmacológico mais atuais. A rinite é uma doença decorrente da inflamação e ou disfunção da mucosa de revestimento nasal e das estruturas subjacentes, mediada por imunoglobulinas após a exposição a um alérgeno. Trata-se de uma doença mais prevalente na infância e é caracterizada por sintomas como obstrução nasal, rinorreia anterior e posterior, espirros, prurido nasal e hiposmia. O tratamento da rinite alérgica é baseado no controle da exposição aos alérgenos e, quando não é suficiente, é adicionado o tratamento farmacológico. Atualmente, a imunoterapia tem sido amplamente e estudada e utilizada de maneira segura e eficaz, com o objetivo reduzir os sintomas numa próxima exposição e induzir tolerância a longo prazo. As principais formas de administração de imunoterapia analisadas foram a sublingual, subcutânea e nasal. Os estudos comprovaram a eficácia da via subcutânea e sublingual, aceitas como boa forma de tratamento. Ao comparar a segurança entre ambas as vias, a sublingual apresentou efeitos adversos mais brandos e de fácil resolução

Bos d 13, a novel heat-stable beef allergen

[Scope]: Red meat, a staple food of Western diets, can also induce IgE-mediated allergic reactions. Yet, apart from the heat-labile protein serum albumin and the carbohydrate α-Gal, the molecules causing allergic reactions to red meat remain unknown.[Methods and results]: IgE reactivity profiles of beef-sensitized individuals are analyzed by IgE-immunoblotting with protein extracts from raw and cooked beef. Two IgE-reactive proteins are identified by peptide mass fingerprinting as myosinlight chain 1 (MYL1) and myosin light chain 3 (MYL3) in cooked beef extract and are designated Bos d 13 isoallergens. MYL1 and MYL3 are produced recombinantly in Escherichia coli. ELISAs proved their IgE reactivity and circular dichroism analysis showed that they represent folded molecules with remarkable thermal stability. In vitro gastrointestinal digestion experiments showed the higher stability of rMYL1 as compared to rMYL3. Exposure of a monolayer of Caco-2 cells to rMYL1 indicated that the molecule is able to cross intestinal epithelial cells without disturbing the integrity of the tight junctions, suggesting the sensitizing capacity of MYL1.[Conclusion]: MYLs are identified as novel heat-stable bovine meat allergens.This research was funded in whole by the Austrian Science Fund (FWF) P33867.Peer reviewe

Insulin and the kidneys: a contemporary view on the molecular basis

Insulin is a hormone that is composed of 51 amino acids and structurally organized as a hexamer comprising three heterodimers. Insulin is the central hormone involved in the control of glucose and lipid metabolism, aiding in processes such as body homeostasis and cell growth. Insulin is synthesized as a large preprohormone and has a leader sequence or signal peptide that appears to be responsible for transport to the endoplasmic reticulum membranes. The interaction of insulin with the kidneys is a dynamic and multicenter process, as it acts in multiple sites throughout the nephron. Insulin acts on a range of tissues, from the glomerulus to the renal tubule, by modulating different functions such as glomerular filtration, gluconeogenesis, natriuresis, glucose uptake, regulation of ion transport, and the prevention of apoptosis. On the other hand, there is sufficient evidence showing the insulin receptor’s involvement in renal functions and its responsibility for the regulation of glucose homeostasis, which enables us to understand its contribution to the insulin resistance phenomenon and its association with the progression of diabetic kidney disease

Conching chocolate:A prototypical transition from frictionally jammed solid to flowable suspension with maximal solid content

The mixing of a powder of 10-50{\mu}m primary particles into a liquid to form a dispersion with the highest possible solid content is a common industrial operation. Building on recent advances in the rheology of such 'granular dispersions', we study a paradigmatic example of such powder incorporation: the conching of chocolate, in which a homogeneous, flowing suspension is prepared from an inhomogeneous mixture of particulates, triglyceride oil and dispersants. Studying the rheology of a simplified formulation, we find that the input of mechanical energy and staged addition of surfactants combine to effect a considerable shift in the jamming volume fraction of the system, thus increasing the maximum flowable solid content. We discuss the possible microscopic origins of this shift, and suggest that chocolate conching exemplifies a ubiquitous class of powder-liquid mixing