Sprouting of oats: a new approach to quantify compositional changes

Background and objectives: The aim of this research was to gain a deeper insight into the effect caused by the addition of sprouted oat to food products. The effect of temperature and duration of the sprouting process was systematically studied by sprouting oat grains between 10 and 30°C for up to 3 days. Findings: Overall, it was found that temperatures between 20 and 25°C yield the most dramatic changes in the properties of sprouted oats. Based on the data, a simple system to characterize the sprouting progress by a visual inspection of the lengths of the coleoptile and radicles was developed. This degree of sprouting (DoS) was correlated with further grain properties. Conclusions: It was found that an exponential relationship between the DoS and grain properties existed. Furthermore, the observed increase in the reducing sugar content (up to 14.6 g/100 g) with increasing DoS was closely related to the increase in α‐amylase activity (up to 25 U/g). Significance and novelty: The good predictive power found indicates that the application of the concept degree of sprouting could develop into a reliable characterization method for sprouted grains usable for product development and specification.TU Berlin, Open-Access-Mittel - 201

Effect of sprouting temperature on selected properties of wheat flour and direct expanded extrudates

The effect of the sprouting temperature on wheat sprouting and on the properties of expanded extrudates produced from sprouted wheat flour was studied. Therefore, wheat was sprouted at five different temperatures and subsequently dried, milled, and the resulting flour was used to produce extrudates using a twin‐screw extruder. In order to understand the sprouting temperature effect, the degree of sprouting (DoS) of the differently sprouted samples and characteristic properties of flour and extrudates were studied and compared. During sprouting of wheat with increasing temperature and time an increase of the α‐amylase activity, the vitamin C and reducing sugar content, and a decrease of the peak viscosity was observed. The greatest effect was found at 20°C. Furthermore, the lowering of the viscosity of the flour suspension results in a reduction of the pressure and temperature in the extruder die. The extrudates of sprouted wheat flour were found to be easier to break, had a lower density, an increased longitudinal expansion index, and an improved cold‐water solubility. A good correlation between the DoS and other properties of flour and extrudates was found, indicating a good predictive power and applicability of the DoS concept for wheat samples and their product development and specification.TU Berlin, Open-Access-Mittel - 202

A Mobile Prenatal Care App to Reduce In-Person Visits: Prospective Controlled Trial.

BACKGROUND: Risk-appropriate prenatal care has been asserted as a way for the cost-effective delivery of prenatal care. A virtual care model for prenatal care has the potential to provide patient-tailored, risk-appropriate prenatal educational content and may facilitate vital sign and weight monitoring between visits. Previous studies have demonstrated a safe reduction in the frequency of in-person prenatal care visits among low-risk patients but have noted a reduction in patient satisfaction. OBJECTIVE: The primary objective of this study was to test the effectiveness of a mobile prenatal care app to facilitate a reduced in-person visit schedule for low-risk pregnancies while maintaining patient and provider satisfaction. METHODS: This controlled trial compared a control group receiving usual care with an experimental group receiving usual prenatal care and using a mobile prenatal care app. The experimental group had a planned reduction in the frequency of in-person office visits, whereas the control group had the usual number of visits. The trial was conducted at 2 diverse outpatient obstetric (OB) practices that are part of a single academic center in Washington, DC, United States. Women were eligible for enrollment if they presented to care in the first trimester, were aged between 18 and 40 years, had a confirmed desired pregnancy, were not considered high-risk, and had an iOS or Android smartphone that they used regularly. We measured the effectiveness of a virtual care platform for prenatal care via the following measured outcomes: the number of in-person OB visits during pregnancy and patient satisfaction with prenatal care. RESULTS: A total of 88 patients were enrolled in the study, 47 in the experimental group and 41 in the control group. For patients in the experimental group, the average number of in-person OB visits during pregnancy was 7.8 and the average number in the control group was 10.2 (P=.01). There was no statistical difference in patient satisfaction (P\u3e.05) or provider satisfaction (P\u3e.05) in either group. CONCLUSIONS: The use of a mobile prenatal care app was associated with reduced in-person visits, and there was no reduction in patient or provider satisfaction. TRIAL REGISTRATION: ClinicalTrials.gov NCT02914301; https://clinicaltrials.gov/ct2/show/NCT02914301 (Archived by WebCite at http://www.webcitation.org/76S55M517)

Aortic Dissection Type A in Alpine Skiers

Patients and Methods. 140 patients with aortic dissection type A were admitted for cardiac surgery. Seventy-seven patients experienced their dissection in the winter season (from November to April). We analyzed cases of ascending aortic dissection associated with alpine skiing. Results. In 17 patients we found skiing-related aortic dissections. Skiers were taller (180 (172-200) cm versus 175 (157-191) cm, = 0.008) and heavier (90 (68-125) kg versus 80 (45-110) kg, = 0.002) than nonskiers. An extension of aortic dissection into the aortic arch, the descending thoracic aorta, and the abdominal aorta was found in 91%, 74%, and 69%, respectively, with no significant difference between skiers and nonskiers. Skiers experienced RCA ostium dissection requiring CABG in 17.6% while this was true for 5% of nonskiers ( = 0.086). Hospital mortality of skiers was 6% versus 13% in nonskiers ( = 0.399). The skiers live at an altitude of 170 (0-853) m.a.s.l. and experience their dissection at 1602 (1185-3105; < 0.001) m.a.s.l. In 82% symptom start was during recreational skiing without any trauma. Conclusion. Skiing associated aortic dissection type A is usually nontraumatic. The persons affected live at low altitudes and practice an outdoor sport at unusual high altitude at cold temperatures. Postoperative outcome is good

Targeted delivery of a vaccine protein to Langerhans cells in the human skin via the C-type lectin receptor Langerin

Human skin is a preferred vaccination site as it harbors multiple dendritic cell (DC) subsets, which display distinct C-type lectin receptors (CLR) that recognize pathogens. Antigens can be delivered to CLR by antibodies or ligands to boost antigen-specific immune responses. This concept has been established in mouse models but detailed insights into the functional consequences of antigen delivery to human skin DC in situ are sparse. In this study, we cloned and produced an anti-human Langerin antibody conjugated to the EBV nuclear antigen 1 (EBNA1). We confirmed specific binding of anti-Langerin-EBNA1 to Langerhans cells (LC). This novel LC-based vaccine was then compared to an existing anti-DEC-205-EBNA1 fusion protein by loading LC in epidermal cell suspensions before coculturing them with autologous T cells. After restimulation with EBNA1-peptides, we detected elevated levels of IFN-γ- and TNF-α-positive CD4+ T cells with both vaccines. When we injected the fusion proteins intradermally into human skin explants, emigrated skin DC targeted via DEC-205-induced cytokine production by T cells, whereas the Langerin-based vaccine failed to do so. In summary, we demonstrate that antibody-targeting approaches via the skin are promising vaccination strategies, however, further optimizations of vaccines are required to induce potent immune responses

ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients

Untersuchung der Verwendung von gekeimten Getreide als Ausgangsstoff für die Herstellung von direkt expandiertem Getreide

The use of sprouted grains in the production of directly expanded breakfast cereals is a promising opportunity to produce health‐promoting, newly flavored, and colored products with less additive sugar. Hardly any knowledge about the effect of the variation of the sprouting conditions on properties of extrudate products produced on the basis of these differently sprouted samples and methods to evaluate the progress of the sprouting process exists. Therefore, this work aimed to get a deeper insight into these issues. For this purpose, a simple and standardized system, the degree of sprouting method, was developed to characterize the sprouting progress by a visual inspection of the lengths of the coleoptile and radicles. Eight degrees of sprouting were defined. To test this method, wheat and oat grains were sprouted for different periods and at different temperatures. The grains were then processed by drying, milling, and extruding them using a twin‐screw extruder. The sprouted grains were assigned a degree of sprouting to determine the average degree of sprouting of all grains sprouted under the given conditions. The average degree of sprouting was subsequently correlated with the flour and extrudate properties. The presented study indicated that the degree of sprouting concept is a reliable method to predict product properties and is, therefore, of use for product development and specification. Furthermore, the results of the investigation of different sprouting times and temperatures on the properties of the resulting flours and extrudates provided new valuable insights. By sprouting the grains at 20 °C and/or for long sprouting periods of up to 9 days the most significant changes in the flour and extrudate properties were determined. Extrudates based on sprouted wheat were found to expand less, have bigger pores, a darker color, a softer structure, and were more water‐ soluble. These findings were attributed to the reduction in the starch content as the result of the enhanced enzyme activity during sprouting, the accompanying increase in the reducing sugar content, and reduction in the peak viscosity while heating the sprouted grain flour suspension. Furthermore, the increase in reducing sugars and amino acids enhanced the formation of colorants and flavors as part of the Maillard reaction and provided sweeter products without the need for additional sugar. A sensory panel confirmed these findings and also preferred the extrudates based on sprouted grain flour.Furthermore, the newly produced extrudates have a higher nutritional value as they are based on whole grain flour and show a higher vitamin content. The nutritional improvement of the sprouted grains compared to native grains was indicated by the increase in vitamin C content. Even after the high‐temperature‐short‐time extrusion process most of the vitamin C content was preserved. By use of another new method developed in this research work, the average molecular weight changes of the starch molecules isolated from sprouted grain flour were shown. Due to the sprouting process, the average molecular weight of the starch decreases. The results indicated a degradation of the amylopectin into smaller molecules. The reduction was accompanied by significant changes in thermal and rheological characteristics of the sprouted grain flours, which is important for future product applications. Furthermore, this study demonstrated significant differences in the sprouting behavior of oat and wheat. Wheat was found to have a higher enzyme activity compared to oat and hence, a higher degradation rate of polysaccharides. In summary, the present thesis shows a promising new method to evaluate the progress of the sprouting process and discusses the application of sprouted grains in directly expanded breakfast cereals.Die Verwendung von gekeimten Getreide bei der Herstellung von direkt expandierten Frühstückszerealien stellt eine vielversprechende Möglichkeit dar, gesundheitsfördernde Produkte mit neuen Aromen und Farbe und mit weniger Zuckerzusatz herzustellen. Es gibt jedoch keine Forschungserkenntnisse über den Einfluss der unterschiedlichen Keimungsbedingungen auf die Eigenschaften von Extrudatprodukten, die auf der Basis dieser unterschiedlich gekeimten Proben hergestellt werden. Des Weiteren existiert keine standardisierte Methode zur schnellen Beurteilung des Keimfortschritts. Das Ziel dieser Arbeit war es ein tieferes Verständnis für diese Thematiken zu erhalten. Zu diesem Zweck wurde ein einfaches und standardisiertes System, der sogenannte Keimungsgrad, entwickelt, um den Keimungsfortschritt durch eine visuelle Beurteilung der Länge des Wurzel‐ und Blattkeims zu beschreiben. Dazu wurden acht Keimungsgrade definiert. Um diese Methode zu testen wurden Weizen‐ und Haferkörner für unterschiedliche Zeiten und bei unterschiedlichen Temperaturen gekeimt. Daraufhin wurden die Körner getrocknet, gemahlen und mit Hilfe eines Doppelschneckenextruders extrudiert. Den gekeimten Körnern wurde ein Keimungsgrad zugeordnet, um anschließend den durchschnittlichen Keimungsgrad aller unter den bestimmten Bedingungen gekeimten Körner zu bestimmen. Der durchschnittliche Keimungsgrad wurde anschließend mit den Mehl‐ und Extrudateigenschaften korreliert. Die hier präsentierten Ergebnisse zeigten, dass das Konzept des Keimungsgrades eine belastbare Methode zur Vorhersage von Produkteigenschaften ist und daher für die Produktentwicklung und‐spezifikation von großem Nutzen sein kann. Des Weiteren, lieferten die Ergebnisse der Untersuchung der unterschiedlichen Keimungszeiten und ‐temperaturen auf die Eigenschaften der resultierenden Mehle und Extrudate neue, interessante Erkenntnisse. Durch das Keimen der Körner bei 20 °C und/oder Keimen bis zu 9 Tagen konnten in dieser Arbeit die signifikantesten Veränderungen der Mehl‐ und Extrudateigenschaften gefunden werden. Es wurde festgestellt, dass Extrudate auf der Basis von gekeimtem Weizen weniger expandieren, sowie größere Poren, eine dunklere Farbe, eine weniger feste Struktur und eine bessere Wasserlöslichkeit aufweisen. Diese Ergebnisse werden auf die Verringerung des Stärkegehalts durch die starke Zunahme der Enzymaktivitäten während der Keimung, die damit einhergehende Erhöhung des reduzierenden Zuckergehalts und die daraus resultierende Verringerung der Heißviskosität der Suspensionen von gekeimten Getreide zurückgeführt. Darüber hinaus verstärkte die erhöhte Konzentration der reduzierenden Zucker und der Aminosäuren die Bildung von Farb‐ und Aromastoffen als Teil der Maillard‐Reaktion und lieferte süßere Produkte ohne die Notwendigkeit des Zusatzes von weiterem Zucker. Ein Sensorik‐Panel bestätigte diese Ergebnisse und bevorzugte ebenfalls die Extrudate auf der Basis von gekeimten Getreide. Des Weiteren weisen die neu hergestellten Extrudate einen höheren Nährwert auf, da sie auf der Basis von Vollkornmehl hergestellt sind und einen höheren Vitamingehalt besitzen. Die ernährungsphysiologische Verbesserung des gekeimten Getreides im Vergleich zu nativem Getreide wurde durch die Erhöhung des Vitamin‐C‐Gehalts bewiesen. Auch nach dem Hochtemperatur‐ Kurzzeit‐Extrusionsprozess blieb der Vitamin‐C‐Gehalt weitgehend erhalten. Mit Hilfe einer neuen Methode, die ebenfalls in dieser Forschungsarbeit entwickelt wurde, konnte die Veränderung im mittleren gewichteten Molekulargewicht der aus gekeimten Getreide isolierten Stärkemoleküle gezeigt werden. Durch den Keimungsprozess nimmt das mittlere gewichtete Molekulargewicht der Stärke ab. Die Ergebnisse zeigten einen Abbau des Amylopektins in kleinere Moleküle. Dieser Abbau ging mit signifikanten Veränderungen der thermischen und rheologischen Eigenschaften des gekeimten Getreidemehls einher, was von großer Bedeutung für zukünftige Produktanwendungen ist. Darüber hinaus zeigte diese Arbeit signifikante Unterschiede im Keimungsverhalten von Hafer und Weizen auf. Es wurde festgestellt, dass Weizen im Vergleich zu Hafer eine höhere Enzymaktivität und damit eine höhere Abbaurate der Polysaccharide aufweist. Zusammenfassend stellt die vorliegende Arbeit eine vielversprechende neue Methode zur Bewertung des Keimungsfortschritts vor und diskutiert die Anwendung von gekeimten Getreide in direkt expandierten Frühstückszerealien

AVALIAÇÃO DA ATIVAÇÃO DOS MÚSCULOS DO CORE DE ACADÊMICOS DO CURSO DE FISIOTERAPIA

Core é definido como o complexo lombo-pélvico dos quadris, onde localiza-se o centro de gravidade e onde têm início todos os movimentos. Um core estável garante saúde corporal e resistência ao longo dia de trabalho de um fisioterapeuta. Avaliar a estabilidade do core de acadêmicos de Fisioterapia é o objetivo do presente estudo, sendo ele descritivo, com 21 estagiários voluntários do curso de Fisioterapia do Centro Universitário Franciscano, RS. Para coletar dados foi utilizado um questionário desenvolvido pelos pesquisadores e para avaliação do core (multífido e transverso do abdômen) foi utilizado esfigmomanômetro como unidade de biofeedback pressórico. A avaliação do core dos acadêmicos demonstrou que estes possuem deficiência da ativação do multífido, podendo, na prática profissional, acarretar em queixas de dor, afetando a qualidade de vida e do trabalho. Sugere-se que o fisioterapeuta incorpore exercícios para a estabilidade central para a diminuição da dor e aumento da força muscular

Testing the Feasibility of Remote Patient Monitoring in Prenatal Care Using a Mobile App and Connected Devices: A Prospective Observational Trial.

BACKGROUND: Excessive weight gain and elevated blood pressure are significant risk factors for adverse pregnancy outcomes such as gestational diabetes, premature birth, and preeclampsia. More effective strategies to facilitate adherence to gestational weight gain goals and monitor blood pressure may have a positive health benefit for pregnant women and their babies. The impact of utilizing a remote patient monitoring system to monitor blood pressure and weight gain as a component of prenatal care has not been previously assessed. JMIR Res Protoc 2016 Nov; 5(4):e200. OBJECTIVE: The objective of this study is to determine the feasibility of monitoring patients remotely in prenatal care using a mobile phone app and connected digital devices. METHODS: In this prospective observational study, 8 women with low risk pregnancy in the first trimester were recruited at an urban academic medical center. Participants received a mobile phone app with a connected digital weight scale and blood pressure cuff for at-home data collection for the duration of pregnancy. At-home data was assessed for abnormal values of blood pressure or weight to generate clinical alerts to the patient and provider. As measures of the feasibility of the system, participants were studied for engagement with the app, accuracy of remote data, efficacy of alert system, and patient satisfaction. RESULTS: Patient engagement with the mobile app averaged 5.5 times per week over the 6-month study period. Weight data collection and blood pressure data collection averaged 1.5 times and 1.1 times per week, respectively. At-home measurements of weight and blood pressure were highly accurate compared to in-office measurements. Automatic clinical alerts identified two episodes of abnormal weight gain with no false triggers. Patients demonstrated high satisfaction with the system. CONCLUSIONS: In this pilot study, we demonstrated that a system using a mobile phone app coupled to remote monitoring devices is feasible for prenatal care