Effect of fermentation on the chemical composition of wheat (triticum aestivum) and maize (zea mays) flours and sensory evaluation of biscuits made from their flours

Background: Fermentation improves the nutritional value, acceptability and safety of foods. Objective: This study assessed the effect of fermentation on the chemical composition of wheat and maize flours and consumer acceptability of biscuits made from their flours. Methods: Fermentation of wheat and maize: Wheat and maize grains were sorted respectively and were divided into five parts of 200g each. They were labelled as W ,W ,W ,W and W for wheat and M ,M M ,M and M for 0 1 2 3 4 0 1, 2 3 4 maize samples. Each sample was washed with tap water three times. W and M were not fermented while W ,W ,W 0 0 1 2 3 and W and M M ,M and M were soaked in 500mls of water in a bowl and were fermented for 24 hours, 48 hours, 4 1, 2 3 4 72 hours and 96 hours respectively. The flour of each sample was used for baking biscuits. Proximate, mineral and vitamin content of the flour samples and the sensory properties of the biscuits produced from their flour were evaluated using standard analytical methods. One way analysis of variance and Duncan's multiple range test were used to separate the means among the samples. Result: The highest ash (2.14%), crude fibre (2.03%) and fat (4.24%) values were observed in sample M . Sample 0 M , W and W had the highest moisture (9.67%), protein (11.62%) and carbohydrate (77.89%) values respectively. 4 4 0 Sample M had the highest magnesium (35.62mg), potassium (162.59mg) and sodium (13.79mg) values, M had 0 1 the highest iron (0.76mg) content while the highest calcium (18.77mg) zinc (0.75mg) and phosphorus (132.59mg) values were observed in sample W . The highest vitamin B (0.59mg), vitamin B (0.24mg), vitamin A (18.76μg) 0 1 3 and folic acid (41.64mg) were observed in sample M while the highest vitamin B (0.04mg) value was found in 0 2 both sample M and sample M Sample W had the highest vitamin C (6.36mg) and vitamin B (1.87mg) content. 0 1. 0 6 There was no significant(p>0.05) difference in the acceptability of the biscuit samples. However, the taste, aroma,texture and general acceptability of the biscuits produced from all the samples had appreciable ratings. Conclusion: Fermentation improved the nutritional quality of cereals while biscuits produced from fermented cereals were generally acceptable

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)