Physical properties of Brazil nuts.

The Brazil-nut, also known as Para-nut, is widely used as food and in cosmetic industries. The seeds are rich in lipids and protein, and also present a considerable amount of selenium. Limited research has been conducted on postharvest of the Brazil nut, being an important information to design equipment related to aeration, drying, storage and transportation steps. Thus, the objective of this study was to determine the physical properties of the Brazil-nut with and without tegument. The dimensions found for the almonds with tegument were 39.35 mm in the X axis, 24.19 mm in the Y axis, and 17.88 mm in the Z axis. However for the almond without tegument the values were 31.05 mm in X, 14.38 in Y and 15.91 mm in Z axis. The sphericity was 66.40% and 51.59% for the kernels with and without seed tegument respectively. The kernels with and without tegument presented sphericity of 63.00% and 47.72% respectively. The mass of 1000 almonds was 6.13 kg for almond with teguments and 3.18 kg for almonds without teguments. Specific mass of 0.947 g.cm-3 and 1.003 g.cm-3 for the kernels with and without tegument, coupled with a porosity of 46.88% and 37.60% and, resulting on a bulk density of 0.504 g.cm-3 and 0.626 g.cm-3 for almonds with and without teguments respectively. Finally, the angle of repose for the kernels with teguments was 36.37°. A castanha-do-brasil, também conhecida como castanha-do-pará, é muito utilizada na alimentação humana e na indústria cosmética. As sementes são ricas em lipídeos e proteínas, apresentando ainda uma quantidade considerável de Selênio. Poucas pesquisas vêm sendo realizadas na pós-colheita do produto, sendo as propriedades físicas importantes para o desenvolvimento de equipamentos relacionados à aeração, secagem, armazenamento e transporte de produtos. Assim, neste trabalho, teve-se por objetivos: determinar as propriedades físicas da castanha-do-brasil com e sem tegumento. O tamanho para as amêndoas com tegumento, foi de 39,35 mm no eixo X, 24,19 mm no eixo Y e 17,88 mm no eixo Z; já para a amêndoa sem tegumento os valores foram de 31,05 mm em X, 14,38 mm em Y e 15,91 em Z. A esfericidade foi de 66,40% e 51,59%, para as amêndoas com e sem tegumento, respectivamente. 63,00% e 47,72% foram os valores de esfericidade encontrados para as amêndoas com e sem tegumento, respectivamente. A massa de 1.000 amêndoas foi de 6,13 kg para a amêndoa com tegumento e de 3,18 kg para amêndoas sem tegumento. Valores de massa específica de 0,947 g.cm-3 e de 1,003 g.cm-3 para as amêndoas com e sem tegumento, associados a uma porosidade de 46,88% e 37,60%, produziram uma massa específica aparente de 0,504 g.cm-3 e de 0,626 g.cm-3. Finalmente, o ângulo de repouso para as amêndoas com tegumento foi de 36,37°

The relationship between birth order and acute alcohol intoxication among Dutch adolescents

Background: Prior research demonstrated the relationship between birth order and adolescent risky behavior. The possible connection between the presence of siblings and birth order and underage alcohol abuse is unknown. Methods: Our study involves 10 years of data collection on underage alcohol intoxication in Dutch hospitals. A total of 2,234 patients were included in the current study. Results: Adolescents treated for alcohol intoxication less often have no siblings (6.7%) than the population has (14.8%). Furthermore, middle and youngest children are overrepresented in the patient population. Conclusion: The presence of older siblings is a risk factor for acute alcohol intoxication

Associations between Socio-Economic Status and Unfavorable Social Indicators of Child Wellbeing; a Neighbourhood Level Data Design

Background: Living in deprivation is related to ill health. Differences in health outcomes between neighbourhoods may be attributed to neighbourhood socio-economic status (SES). Additional to differences in health, neighbourhood differences in child wellbeing could also be attributed to neighbourhood SES. Therefore, we aimed to investigate the association between neighbourhood deprivation, and social indicators of child wellbeing. Methods: Aggregated data from 3565 neighbourhoods in 390 municipalities in the Netherlands were eligible for analysis. Neighbourhood SES scores and neighbourhood data on social indicators of child wellbeing were used to perform repeated measurements, with one year measurement intervals, over a period of 11 years. Linear mixed models were used to estimate the associations between SES score and the proportion of unfavorable social indicators of child wellbeing. Results: After adjustment for year, population size, and clustering within neighbourhoods and within a municipality, neighbourhood SES was inversely associated with the proportion of ‘children living in families on welfare’ (estimates with two cubic splines: −3.59 [CI: −3.99; −3.19], and −3.00 [CI: −3.33; −2.67]), ‘delinquent youth’ (estimate −0.26 [CI: −0.30; −0.23]) and ‘unemployed youth’ (estimates with four cubic splines: −0.41 [CI: −0.57; −0.25], −0.58 [CI: −0.73; −0.43], −1.35 [−1.70; −1.01], and −0.96 [1.24; −0.70]). Conclusions: In this study using repeated measurements, a lower neighbourhood SES was significantly associated with a higher prevalence of unfavorable social indicators of child wellbeing. This contributes to the body of evidence that neighbourhood SES is strongly related to child health and a child’s ability to reach its full potential in later life. Future studies should consist of larger longitudinal datasets, potentially across countries, and should attempt to take the interpersonal variation into account with more individual-level data on SES and outcomes

Borderline ovarian tumor frozen section diagnoses with features suspicious of invasive cancer:a retrospective study

Abstract Background A frozen section diagnosis of a borderline ovarian tumor with suspicious features of invasive carcinoma (“at least borderline” or synonymous descriptions) presents us with the dilemma of whether or not to perform a full ovarian cancer staging procedure. Quantification of this dilemma may help us with the issue of this clinical decision. The present study assessed and compared both the prevalence of straightforward borderline and “at least borderline” frozen section diagnoses and the proportion of these women with a final histopathological diagnosis of invasive carcinoma, with a special interest in histologic subtypes. Methods A retrospective cohort study was performed in three hospitals in The Netherlands. All women that underwent ovarian surgery with perioperative frozen section evaluation in one of these hospitals between January 2007 and July 2018 were identified and included in case of a borderline or “at least borderline” frozen section diagnosis and a borderline ovarian tumor or invasive carcinoma as a final diagnosis. Results A total of 223 women were included, of which 41 women (18.4%) were diagnosed with “at least borderline” at frozen section. Thirteen of forty-one women (31.7%) following “at least borderline” frozen section diagnosis and 14 of 182 women (7.7%) following a straightforward borderline frozen section diagnosis were diagnosed with invasive carcinoma at paraffin section evaluation (p < 0.001). When compared to straightforward borderline frozen section diagnoses, the proportion of women diagnosed with invasive carcinoma increased from 3.1 to 35.7% for serous tumors (p = 0.001), 10.0 to 21.7% for mucinous tumors (p = 0.129) and 50.0 to 75.0% (p = 0.452) in case of other histologic subtypes following an “at least borderline” frozen section diagnosis. Conclusions Overall, when compared to women with a decisive borderline frozen section diagnosis, women diagnosed with “at least borderline” frozen section diagnoses were found to have a higher chance of carcinoma upon final diagnosis (7.7% vs 31.7%). Especially in the serous subtype, full staging during initial surgery might be considered after preoperative consent to prevent a second surgical procedure or chemotherapy in unstaged women. Further studies are needed to evaluate whether additional sampling in case of an “at least borderline” diagnosis may decrease the risk of surgical over-treatment

Targeted social care for highly vulnerable pregnant women: Protocol of the Mothers of Rotterdam cohort study

Introduction: Social vulnerability is known to be related to ill health. When a pregnant woman is socially vulnerable, the ill health does not only affect herself, but also the health and development of her (unborn) child. To optimise care for highly vulnerable pregnant women, in Rotterdam, a holistic programme was developed in close collaboration between the university hospital, the local government and a non-profit organisation. This programme aims to organise social and medical care from pregnancy until the second birthday of the child, while targeting adult and child issues simultaneously. In 2014, a pilot in the municipality of Rotterdam demonstrated the significance of this holistic approach for highly vulnerable pregnant women. In the Mothers of Rotterdam' study, we aim to prospectively evaluate the effectiveness of the holistic approach, referred to as targeted social care. Methods and analysis: The Mothers of Rotterdam study is a pragmatic prospective cohort study planning to include 1200 highly vulnerable pregnant women for the comparison between targeted social care and care as usual. Effectiveness will be compared on the following outcomes: (1) child development (does the child show adaptive development at year 1?) and (2) maternal mental health (is maternal distress reduced at the end of the social care programme?). Propensity scores will be used to correct for baseline differences between both social care programmes. Ethics and dissemination: The prospective cohort study was approved by the Erasmus Medical Centre Ethics Committee (ref. no. MEC-2016-012) and the first results of the study are expected to be available in the second half of 2019 through publication in peer-reviewed international journals. Trial registration number NTR6271; Pre-results

Surgery for Ampullary Cancer in a Patient with Pancreatic Lipomatosis Caused by Cystic Fibrosis

A patient with cystic fibrosis (CF) with pancreatic insufficiency presented with jaundice due to an ampullary tumour. CF is known for a higher incidence of gastrointestinal malignancies. The patient suffered from pancreatic insufficiency. At computed tomography (CT), pancreatic lipomatosis with absence of the pancreatic duct was seen. This is uncommon, also in patients with CF. During surgery, a total pancreatectomy was performed, because there was no possibility to construct a duct to mucosa anastomosis due to the absence of the pancreatic duct and more importantly the pancreas was already afunctional. The presence of lipomatosis increases the risk of leakage at the pancreaticojejunal anastomosis. Therefore, it is important to take this phenomenon, in this case already visible on the preoperative CT scan, into account during the workup for surgery