Multiple response optimization of blueberry juice depectinization

To obtain blueberry juice with a high content of antioxidants it is necessary to introduce an enzymatic depectinization step into the process. Due to the importance of this step in the final properties of blueberry juice it is critical that the operation conditions be optimized. The aim of this research was to evaluate the effects of temperature, duration of treatment and enzymatic complex concentration on anthocyanin content and juice yield during enzymatic depectinization. Results indicated that the best factor combination was 50ºC during 1.3h and 4mg 100g-1 of LAFASE(r) CLARIFICATION and 8mg 100g-1 of LAFASE(r) HE GRAND CRU enzymatic complex concentration. Under these conditions, blueberry juice with 798.41±8.03mg of cyanidin-3-glucoside L-1 and a juice yield of 87% was obtained. The combination of the response surface and desirability function methodologies enabled the optimization of the blueberry juice during the depectinization step, in terms of anthocyanin content and juice yield

Drying kinetics modeling of apple and zucchini slices vacuum impregnated with anthocyanins

The aim of this research was to study the drying kinetics of apple and zucchini slices enriched with anthocyanins and to evaluate the influence of drying temperature on the anthocyanin content of apple and zucchini snacks. Apple (Granny Smith) and zucchini (Cucurbita pepo) slices were enriched with anthocyanins by vacuum impregnation with blueberry juice. Then, slices were dehydrated at 40, 50 and 60 ºC with 1.0 m/s air flow. Dehydrated samples were referred to as anthocyanin enriched snacks. Diffusion coefficient values improved by increasing the drying temperature, within the 2.81×10-10 to 5.78×10-10 m2/s range for apple slices and 2.02×10-10 to 3.99×10-10 m2/s for zucchini slices. The activation energy was 31.19 kJ/mol and 80.33 kJ/mol for apple and zucchini slices respectively. Page, Weibull, Logarithmic, Henderson-Pabis and Lewis models best fitted the experimental data. Snacks obtained at 60 °C retained a higher concentration of anthocyanins, reaching values of 592.81±52.55 and 464.62±48.44 mg of cyaniding-3-glucoside equivalent/kg dry matter in apple and zucchini snacks respectively. Combination of vacuum impregnation and hot air drying was a technological alternative for producing snacks with functional properties

Estabilidad de antocianinas durante el almacenamiento de jugos de arándanos

Los arándanos y productos de arándano tienen alto valor nutricional, especialmente por su alto contenido de antocianinas. Estas son potentes antioxidantes y poseen alta capacidad de secuestrar radicales libres. Así, los arándanos y productos de arándanos han resultado atractivos para los consumidores interesados en alimentos funcionales. Sin embargo, los tratamientos térmicos y posterior almacenamiento de productos alimenticios influyen en el contenido de antocianinas. La cinética de degradación de las antocianinas puede ser evaluada desde una perspectiva termodinámica, basada en funciones como energía libre, entalpía, entropía y energía de activación. Objetivos: Se estudió el efecto de la pasteurización y la estabilidad de antocianinas presentes en jugos de arándanos, sin pasteurizar y pasteurizados, durante el almacenamiento. Métodos: Jugos de arándanos sin pasteurizar y pasteurizados fueron almacenados a -18, 0, 5 y 10°C durante 148 días. A intervalos de tiempos se cuantificó la concentración de antocianinas monoméricas totales. Se realizó un Análisis de Componentes Principales y los resultados experimentales se ajustaron a modelos cinéticos de orden cero y uno, y a los modelos de Arrhenius y Eyring. Resultados: La pasteurización provocó disminución del 28,5% en la concentración inicial de antocianinas monoméricas totales, mientras que para todas las temperaturas estudiadas, la disminución de antocianinas en función del tiempo de almacenamiento siguió una cinética de primer orden. En el jugo sin pasteurizar, la constante de velocidad de degradación varió entre 0,0080 - 0,0084 días-1 y el tiempo de vida media, entre 75 - 87 días. En el jugo pasteurizado, la constante de velocidad de degradación varió entre 0,0023 - 0,0060 días-1 y el tiempo de vida media, entre 116-301 días. En éste la energía de activación, la energía libre de Gibbs, entalpía y entropía de activación fueron 44,66 kJ/mol, 83,80 kJ/mol, 42,35 kJ/mol y -139,09 J/mol.K, respectivamente'. Conclusiones: El tratamiento de pasteurización provocó disminución del 28,5% en la concentración de antocianinas monoméricas totales iniciales de los jugos de arándano. La estabilidad de las antocianinas durante el almacenamiento fue mayor en los jugos pasteurizados, siendo mayor cuando se almacenaron a 0°C; mientras que en los jugos pasteurizados almacenados a -18°C las antocianinas mostraron menor estabilidad

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Multiple response optimization of blueberry juice depectinization

ABSTRACT: To obtain blueberry juice with a high content of antioxidants it is necessary to introduce an enzymatic depectinization step into the process. Due to the importance of this step in the final properties of blueberry juice it is critical that the operation conditions be optimized. The aim of this research was to evaluate the effects of temperature, duration of treatment and enzymatic complex concentration on anthocyanin content and juice yield during enzymatic depectinization. Results indicated that the best factor combination was 50ºC during 1.3h and 4mg 100g-1 of LAFASE(r) CLARIFICATION and 8mg 100g-1 of LAFASE(r) HE GRAND CRU enzymatic complex concentration. Under these conditions, blueberry juice with 798.41±8.03mg of cyanidin-3-glucoside L-1 and a juice yield of 87% was obtained. The combination of the response surface and desirability function methodologies enabled the optimization of the blueberry juice during the depectinization step, in terms of anthocyanin content and juice yield

Development of a prediction model for postoperative pneumonia A multicentre prospective observational study

BACKGROUND Postoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems. OBJECTIVE To identify independent variables associated with the occurrence of postoperative pneumonia. DESIGN A prospective observational study of a multicentre cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe database). SETTING Sixty-three hospitals in Europe. PATIENTS Patients undergoing surgery under general and/or regional anaesthesia during a 7-day recruitment period. MAIN OUTCOME MEASURE The primary outcome was postoperative pneumonia. Definition: the need for treatment with antibiotics for a respiratory infection and at least one of the following criteria: new or changed sputum; new or changed lung opacities on a clinically indicated chest radiograph; temperature more than 38.3 degrees C; leucocyte count more than 12 000 mu l(-1). RESULTS Postoperative pneumonia occurred in 120 out of 5094 patients (2.4%). Eighty-two of the 120 (68.3%) patients with pneumonia required ICU admission, compared with 399 of the 4974 (8.0%) without pneumonia (P < 0.001). We identified five variables independently associated with postoperative pneumonia: functional status [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.58 to 3.12], pre-operative SpO(2) values while breathing room air (OR 0.83, 95% CI 0.78 to 0.84), intra-operative colloid administration (OR 2.97, 95% CI 1.94 to 3.99), intra-operative blood transfusion (OR 2.19, 95% CI 1.41 to 4.71) and surgical site (open upper abdominal surgery OR 3.98, 95% CI 2.19 to 7.59). The model had good discrimination (c-statistic 0.89) and calibration (Hosmer-Lemeshow P = 0.572). CONCLUSION We identified five variables independently associated with postoperative pneumonia. The model performed well and after external validation may be used for risk stratification and management of patients at risk of postoperative pneumonia

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk