Fortified Blended Food Base: Effect of Co-Fermentation Time on Composition, Phytic Acid Content and Reconstitution Properties

peer-reviewedDehydrated blends of dairy-cereal combine the functional and nutritional properties of two major food groups. Fortified blended food base (FBFB) was prepared by blending fermented milk with parboiled wheat, co-fermenting the blend at 35 ◦C, shelf-drying and milling. Increasing co-fermentation time from 0 to 72 h resulted in powder with lower lactose, phytic acid and pH, and higher contents of lactic acid and galactose. Simultaneously, the pasting viscosity of the reconstituted base (16.7%, w/w, total solids) and its yield stress (σ0), consistency index (K) and viscosity on shearing decreased significantly. The changes in some characteristics (pH, phytic acid, η120) were essentially complete after 24 h co-fermentation while others (lactose, galactose and lactic acid, pasting viscosities, flowability) proceeded more gradually over 72 h. The reduction in phytic acid varied from 40 to 58% depending on the pH of the fermented milk prior to blending with the parboiled cereal. The reduction in phytic acid content of milk (fermented milk)-cereal blends with co-fermentation time is nutritionally desirable as it is conducive to an enhanced bioavailability of elements, such as Ca, Mg, Fe and Zn in milk-cereal blends, and is especially important where such blends serve as a base for fortified-blended foods supplied to food-insecure region

Making Mobile Health about the User: Understanding Primary Healthcare Workers’ Attitudes towards mHealth adoption

This study aims to understand end users’, namely Primary Healthcare (PHC) workers, initial attitudes towards an mHealth project called IMPACT (usIng Mobile Phones for Assessing, Classifying and Treating sick children)

Balancing privacy rights and surveillance analytics: a decision process guide

The right to privacy has been discussed by scholars in multiple disciplines, yet privacy issues are increasing due to technological advances and lower costs for organisations to adopt smart surveillance. Given the potential for misuse, it seems prudent for stakeholders to critically evaluate Surveillance Analytics (SA) innovations. To assist in balancing the issues arising from SA adoption and the implications for privacy, we review key terms and ethical frameworks. Further, we prescribe a two-by-two Surveillance, Privacy, and Ethical Decision (SPED) Process Guide. SPED recommends the use of one or more of three ethical frameworks, Consequence, Duty, and Virtue. The vertical axis in the SPED matrix is the sophistication of an organisation’s SA and the horizontal axis is an assessment of the current privacy level and the rights afforded to the target(s) of surveillance. The proposed decision process guide can assist senior managers and technologists in making decisions about adopting SA

Perceptions of a mobile health intervention for Community Case Management in Malawi: Opportunities and challenges for Health Surveillance Assistants in a community setting

AbstractBackground Improved availability of mobile phones in low- and middle-income countries (LMICs) offer an opportunity to improve delivery of Community Case Management (CCM). Despite enthusiasm for introducing mHealth into healthcare across LMICs, end-user attitudes towards mHealth solutions for CCM are limited. We aimed to explore Health Surveillance Assistants’ (HSAs) perceptions of the Supporting LIFE electronic CCM Application (SL eCCM App) and their experiences incorporating it as part of their clinical practice. Methods This exploratory qualitative study was part of a mixed methods feasibility study investigating whether children under-5 presenting to village clinics could be followed-up to collect patient outcome data. The convenience sample of 12 HSAs enrolled into the feasibility study participated in semi-structured interviews, which were conducted at village clinics after HSAs had field-tested the SL eCCM App over a 10-day period. Interviews explored HSAs perceptions of the SL eCCM App and their experiences in using the App in addition to paper CCM to assess and treat acutely unwell children. Open coding was used to label emerging concepts, which were iteratively defined and developed into six key themes. Results HSAs’ perceived enhanced clinical decision-making, quality of CCM delivery, and work efficiency as opportunities associated with using the SL eCCM App. HSAs believed the inability to retrieve patient records,, cumbersome duplicate assessments/data entry study procedures, and inconsistencies between the SL eCCM App and paper-based CCM guidelines as challenges to implementation. Adding features to the App, such as, permitting communication between colleagues/supervisors, drug stock-out reporting, and community assessments, were identified as potentially supporting HSAs’ many roles in the community. Conclusion This study identified opportunities and challenges associated with using the SL eCCM App in Malawi. This information can be used to inform future development and evaluation of the SL eCCM App, and similar mHealth solutions for CCM in Malawi and other developing countries.

Differential predictors for alcohol use in adolescents as a function of familial risk

Abstract: Traditional models of future alcohol use in adolescents have used variable-centered approaches, predicting alcohol use from a set of variables across entire samples or populations. Following the proposition that predictive factors may vary in adolescents as a function of family history, we used a two-pronged approach by first defining clusters of familial risk, followed by prediction analyses within each cluster. Thus, for the first time in adolescents, we tested whether adolescents with a family history of drug abuse exhibit a set of predictors different from adolescents without a family history. We apply this approach to a genetic risk score and individual differences in personality, cognition, behavior (risk-taking and discounting) substance use behavior at age 14, life events, and functional brain imaging, to predict scores on the alcohol use disorders identification test (AUDIT) at age 14 and 16 in a sample of adolescents (N = 1659 at baseline, N = 1327 at follow-up) from the IMAGEN cohort, a longitudinal community-based cohort of adolescents. In the absence of familial risk (n = 616), individual differences in baseline drinking, personality measures (extraversion, negative thinking), discounting behaviors, life events, and ventral striatal activation during reward anticipation were significantly associated with future AUDIT scores, while the overall model explained 22% of the variance in future AUDIT. In the presence of familial risk (n = 711), drinking behavior at age 14, personality measures (extraversion, impulsivity), behavioral risk-taking, and life events were significantly associated with future AUDIT scores, explaining 20.1% of the overall variance. Results suggest that individual differences in personality, cognition, life events, brain function, and drinking behavior contribute differentially to the prediction of future alcohol misuse. This approach may inform more individualized preventive interventions

Differential predictors for alcohol use in adolescents as a function of familial risk

Abstract: Traditional models of future alcohol use in adolescents have used variable-centered approaches, predicting alcohol use from a set of variables across entire samples or populations. Following the proposition that predictive factors may vary in adolescents as a function of family history, we used a two-pronged approach by first defining clusters of familial risk, followed by prediction analyses within each cluster. Thus, for the first time in adolescents, we tested whether adolescents with a family history of drug abuse exhibit a set of predictors different from adolescents without a family history. We apply this approach to a genetic risk score and individual differences in personality, cognition, behavior (risk-taking and discounting) substance use behavior at age 14, life events, and functional brain imaging, to predict scores on the alcohol use disorders identification test (AUDIT) at age 14 and 16 in a sample of adolescents (N = 1659 at baseline, N = 1327 at follow-up) from the IMAGEN cohort, a longitudinal community-based cohort of adolescents. In the absence of familial risk (n = 616), individual differences in baseline drinking, personality measures (extraversion, negative thinking), discounting behaviors, life events, and ventral striatal activation during reward anticipation were significantly associated with future AUDIT scores, while the overall model explained 22% of the variance in future AUDIT. In the presence of familial risk (n = 711), drinking behavior at age 14, personality measures (extraversion, impulsivity), behavioral risk-taking, and life events were significantly associated with future AUDIT scores, explaining 20.1% of the overall variance. Results suggest that individual differences in personality, cognition, life events, brain function, and drinking behavior contribute differentially to the prediction of future alcohol misuse. This approach may inform more individualized preventive interventions

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Variation in health care providers’ perceptions: decision making based on patient vital signs

Clinical decision making plays an imperative role when delivering healthcare services. To assist healthcare practitioners in decision making activities, Early Warning Scorecards (EWS) have been developed to classify patients based on their vital sign readings. This paper aims to evaluate the variation among healthcare practitioners’ perceptions of vital signs critical ranges and priorities, and if there is a variation between decisions made based on paper-based Modified EWS (MEWS) and electronic MEWS. A survey is conducted to analyse these variations for six vital sign parameters. Further investigation is carried out on the variations in decisions made for six simulated patients using the paper-based MEWS and eMEWS. Thus, the variations of decisions made for a given patient among the survey participants are analysed in light of paper-based MEWS and eMEWS. Therefore, this paper contributes to both theory and practice by identifying variations in health care providers’ perceptions when deciding the actions/treatment of patients