Ghanaian Cocoa (Theobroma cacao L.) Bean Shells Coproducts: Effect of Particle Size on Chemical Composition, Bioactive Compound Content and Antioxidant Activity

The worldwide cocoa bean shell (CBS) generation is estimated at around 900,000 tons. In their composition, this coproduct showed several bioactive compounds like methylxanthines or polyphenolic compounds. Thus, the aim of this work was to investigate the effects of different particle sizes on the chemical composition, physico-chemical, bioactive compounds content, and antioxidant properties of flours obtained from cocoa (Theobroma cacao L.) bean shells. The flours obtained from CBS with different particle sizes had high content of dietary fiber (61.18–65.58 g/100 g). The polyphenolic profile identified seven compounds being epicatechin and catechin (values ranged 4.56–6.33 and 2.11–4.56 mg/g, respectively) as the most abundant compounds. Additionally, the methylxanthines theobromine and caffeine were quantified with values ranging from 7.12 to 12.77 and 4.02 to 6.13 mg/g, respectively. For the fatty acid profile, the principal compounds identified were oleic, stearic and palmitic acids. CBS had antioxidant capacity with all methods assayed. For DPPH, ABTS and FRAP assays values ranged between 2.35–5.53, 3.39–11.55, and 3.84–7.62 mg Trolox equivalents/g sample, respectively. This study suggests that cocoa bean shells may constitute a valuable coproduct for the food industry due to its high content in valuable bioactive compounds

Wage inequality, segregation by skill and the price of capital in an assignment model

Some pieces of empirical evidence suggest that in the U.S., over the last few decades, (i) wage inequality between-plants has risen much more than wage inequality within-plants and (ii) there has been an increase in the segregation of workers by skill into separate plants. This paper presents a frictionless assignment model in which these two features can be explained simultaneously as the result of the decline in the relative price of capital. Additional implications of the model regarding the skill premium and the dispersion in labor productivity across plants are also consistent with the empirical evidence. [resumen de autor

O31 Integrative analysis reveals a molecular stratification of systemic autoimmune diseases

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Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Bioaccessibility of Phenolic Compounds and Antioxidant Capacity of Chia (Salvia hispanica L.) Seeds

The aim of this work was to evaluate (i) the phenol and flavonoid recovery and bioaccessibility indexes and (ii) the antioxidant activity of both types of non-defatted and defatted chia seeds during the in vitro gastrointestinal digestion. The ground samples were subjected to in vitro simulated gastrointestinal digestion, and the resultant fractions were extracted and subjected to spectrophotometric assays. The results pointed to increasing concentrations of polyphenolic compounds during digestion, although only a low-medium percentage of phenols and a low percentage of flavonoids were available for absorption in the intestinal tract. In addition, the high level of fats seemed to have a negative effect on the bioaccessibility of flavonoids. Further studies should be undertaken to better understand the stabilization of the bioactive compounds of chia and to improve their bioaccessibility. Meanwhile, the present study represents a solid base for studying the bioavailability of bioactive compounds of chia seeds

Quinoa (Chenopodium quinoa Willd) paste as partial fat replacer in the development of reduced fat cooked meat product type pâté: Effect on quality and safety

The aim of this work was to evaluate the effect of partially replacing fat by the addition of three quinoa pastes obtained from white, red and black quinoa on the quality and safety of a cooked meat product such as pork liver pâté. The addition of quinoa paste as fat replacer led to an increase in the moisture, ash and residual nitrite contents, while the fat content decreased with respect to control sample by an average of 8%. The use of quinoa pastes increased the hardness and the gumminess but had no effect on springiness and cohesiveness. The substitution of fat with white, red and black quinoa paste at 10% led to lower oxidation rates than observed in the control. No aerobic bacteria, Enterobacteriaceae, moulds and yeasts were found in any sample. The most acceptable sample was the pâté containing red quinoa at 5%

Bioaccessibility of polyphenolic compounds of six quinoa seeds during in vitro gastrointestinal digestion

The aim of this work was to evaluate the effect of simulated in vitro gastrointestinal digestion (GID) on (i) phenol and flavonoid recovery and bioaccessibility indexes, (ii) the antioxidant activity and (iii) the polyphenolic profile of six quinoa seeds. The recovery indexes obtained after the oral, gastric and intestinal digested fractions of quinoa seeds showed increasing concentrations of both total phenolic and flavonoid content. After GID, the average bioaccessibility percentage of samples was 73.29 and 12.64 for phenols and flavonoids, respectively. The LC-MS results obtained showed that the concentration of the polyphenolic compounds analyzed decreased after GID, although DPPH, TEAC-ABTS, FRAP and FIC assays pointed to a large increase in antioxidant activity. Of the investigated samples, red and black quinoa seeds showed the highest antioxidant activity, although they also seemed to be the most affected by GID. Further studies should be undertaken to understand the bioaccessibility of bioactive compounds in quinoa seeds and the factors that interfere with the same