Influence of °Brix/Acid, and flow rate of pineapple juice and electric field strength on the performance of continuous ohmic heating system.

A lab-scale continuous ohmic heating (COH) system was developed, and its performance was studied for pineapple juice heating as a model sample. The effect of independent parameters [°Brix/Acid (unstandardized, 18, 22, 26) and flow rate (80-120 mL/min) of juice and electric field strength (EFS: 25-45 V/cm)] were analysed for responses viz. come-up-time, heating rate (HR) and system performance coefficient (SPC). The full factorial experimental design was used for this study. The results showed that with an increase in °Brix/Acid, the % acidity and electrical conductivity decreased significantly (p < 0.05); thus, the come-up-time to reach 90 °C increased significantly. The HR was significantly (p < 0.05) influenced by °Brix/Acid and EFS but less so by flow rates at higher EFS. The SPC was more than 0.90 and reduced significantly (p < 0.05) with an increase in °Brix/Acid and flow rate. The HR was modeled using a feed-forward back-propagation artificial neural network (ANN) with the best topology of 3, 5, and 1 neurons in the input (independent), hidden, and output (response) layers, respectively. The model performed efficiently, which is evident from the high R2 (0.998) and low RMSE (1.255). Thus, the COH, with its high efficiency and HR, can effectively be used to process fruit juice. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-024-05961-x.

Non-native Intramolecular Radical Cyclization Catalyzed by a B12 -Dependent Enzyme.

Despite the unique reactivity of vitamin B12 and its derivatives, B12 -dependent enzymes remain underutilized in biocatalysis. In this study, we repurposed the B12 -dependent transcription factor CarH to enable non-native radical cyclization reactions. An engineered variant of this enzyme, CarH*, catalyzes the formation γ- and δ-lactams through either redox-neutral or reductive ring closure with marked enhancement of reactivity and selectivity relative to the free B12 cofactor. CarH* also catalyzes an unusual spirocyclization by dearomatization of pendant arenes to produce bicyclic 1,3-diene products instead of 1,4-dienes provided by existing methods. These results and associated mechanistic studies highlight the importance of protein scaffolds for controlling the reactivity of B12 and expanding the synthetic utility of B12 -dependent enzymes.

First and second sphere interactions accelerate non-native N-alkylation catalysis by the thermostable, methanol-tolerant B12-dependent enzyme MtaC.

The corrinoid protein MtaC, which is natively involved in methyl transferase catalysis, catalyzes N-alkylation of aniline using ethyl diazoacetate. Our results show how the native preference of B12 scaffolds for radical versus polar chemistry translates to non-native catalysis, which could guide selection of B12-dependent proteins for biocatalysis. MtaC also has high thermal stability and organic solvent tolerance, remaining folded even in pure methanol.

Resilience related to novel coronavirus among doctors and undergraduate medical students-A study from India.

BACKGROUND: There are no studies pertaining to resilience related to novel coronavirus focusing primarily on doctors and undergraduate medical students in India. The objectives of this survey were to assess the resilience and its various domains that are needed for dealing with novel coronavirus among doctors, interns, and undergraduate students and to see its correlation with various sociodemographic factors. MATERIALS AND METHOD: An online cross-sectional survey was done among doctors and undergraduate medical students during the first COVID-19 wave from May 19, 2020 to June 8, 2020. A total of 434 responses were recorded during the study period. All the recorded full responses were considered for data analysis. Snowball sampling was used for this study. Resilience was assessed using three items, which were taken from the Brief Resilience Scale (BRS). RESULT: Out of 434 responses, 51.7% (224/433) of the respondents were non-resilient. The presence of the elderly at home was significantly associated with poor resilience (P = 0.02). Resilience was not significantly associated with other socio-demographic factors. Younger respondents (P = 0.019) and females (P =0.0004) were of the opinion that they recovered late from stressful events. Elderly respondents (P = 0.003) and those with chronic illness (P = 0.008) reported that it is hard for them to snap back if something bad happens (P = 0.003). CONCLUSIONS: More than half of the doctors and undergraduate medical students were found to be non-resilient, underscoring the urgent need to take steps to improve the resilience of this group of frontline workers.

Gastrointestinal Quality of Life in Morbidly Obese Patients Undergoing One Anastomosis Gastric Bypass (OAGB): Derivation of a "Mini GIQLI" Score.

BACKGROUND: One anastomosis gastric bypass (OAGB) is now one of the mainstream bariatric surgical procedures with proven safety and efficacy. However, data on the gastrointestinal quality of life following OAGB is lacking. METHODS: This is a retrospective analysis of a prospectively collected database, performed at a single tertiary care teaching hospital from January 2016 until March 2021. All patients undertook the Gastrointestinal Quality of Life Index (GIQLI) questionnaire. GIQLI was correlated with various parameters. Principal component analysis (PCA) was used to assess the importance of each question in the questionnaire and devise a "Mini GIQLI score". RESULTS: A total of 60 patients were included. The %TWL at 3 and 5 years was 26.2 ± 11.9%, 31.7 ± 11 respectively. The mean weight regain was 5.6 ± 8.5 kg. The mean GIQLI score was 125 ± 13.1. The mean scores for questions pertaining to gastrointestinal, social, psychological, and physical domains were 3.49, 3.7, 3.45, and 3.27 respectively. Scree plot of principal component analysis showed that a new score ("Mini GIQLI") combining only 5 questions had good correlation with the overall GIQOL score (r = 0.842). The five questions related to anxiety, fatigue, feeling unwell, loss of endurance, and feeling unfit. CONCLUSIONS: Patients report a good score on GIQLI assessment following OAGB. The Mini GIQLI score is a quicker tool with good correlation to the full-length GIQLI score.

Controlling Non-Native Cobalamin Reactivity and Catalysis in the Transcription Factor CarH.

Vitamin B12 derivatives catalyze a wide range of organic transformations, but B12-dependent enzymes are underutilized in biocatalysis relative to other metalloenzymes. In this study, we engineered a variant of the transcription factor CarH, called CarH*, that catalyzes styrene C-H alkylation with improved yields (2-6.5-fold) and selectivity relative to cobalamin. While the native function of CarH involves transcription regulation via adenosylcobalamin (AdoCbl) Co(III)-carbon bond cleavage and ß-hydride elimination to generate 4',5'-didehydroadenosine, CarH*-catalyzed styrene alkylation proceeds via non-native oxidative addition and olefin addition coupled with a native-like ß-hydride elimination. Mechanistic studies on this reaction echo findings from earlier studies on AdoCbl homolysis to suggest that CarH* selectivity results from its ability to impart a cage effect on radical intermediates. These findings lay the groundwork for the development of B12-dependent enzymes as catalysts for non-native transformations.

Impact of COVID-19 pandemic on bariatric surgery in India: An obesity and metabolic surgery society of India survey of 1307 patients.

BACKGROUND: Although safe practice guidelines were issued by the Obesity and Metabolic Surgery Society of India (OSSI) in the end of May 2020, surgeons have been in a dilemma about risk of subjecting patients to hospitalisation and bariatric surgery. This survey was conducted with the objective to evaluate the risk of coronavirus disease-19 (COVID-19) infection in peri- and post-operative period after bariatric and metabolic surgery (BMS). METHODS: A survey with OSSI members was conducted from 20 July 2020 to 31 August 2020 in accordance with EQUATOR guidelines. Google Form was circulated to all surgeon members through E-mail and WhatsAppTM. In the second phase, clinical details were captured from surgeons who reported positive cases. RESULTS: One thousand three hundred and seven BMS were reported from 1 January 2020 to 15 July 2020. Seventy-eight per cent were performed prior to 31 March 2020 and 276 were performed after 1 April 2020. Of these, 13 (0.99%) patients were reported positive for COVID-19 in the post-operative period. All suffered from a mild disease and there was no mortality. Eighty-seven positive cases were reported from patients who underwent BMS prior to 31 December 2019. Of these, 82.7% of patients had mild disease, 13.7% of patients had moderate symptoms and four patients succumbed to COVID-19. CONCLUSION: BMS may be considered as a safe treatment option for patients suffering from clinically severe obesity during the COVID-19 pandemic. Due care must be taken to protect patients and healthcare workers and all procedures must be conducted in line with the safe practice guidelines.

Inclusion of Orogastric Tube in the Staple Line During Laparoscopic Roux-en-Y Gastric Bypass: an Avoidable Complication.

PURPOSE: Laparoscopic Roux-en-Y gastric bypass (LRYGB) involves creation of a small gastric pouch by sequential firing of stapler. During stapler firing, the orogastric tube (OGT) needs to be withdrawn to avoid inclusion in the staple line. We report a rare complication of inadvertent stapling of the OGT during creation of the gastric pouch. MATERIALS AND METHODS: A 37-year old man with body mass index (BMI) of 52.5 kg/m2 and type 2 diabetes mellitus, obstructive sleep apnoea, and gastro-oesophageal reflux disease, underwent LRYGB, with a biliopancreatic limb of 70 cm and an alimentary limb of 130 cm. Before firing the stapler for gastric pouch, the anaesthesia team was requested to withdraw the OGT, and they confirmed that it was done. The stapler was fired without any difficulty. Gastrojejunostomy was also done using linear stapler without any hindrance. The enterotomies were closed with absorbable sutures. Methylene blue leak test was found to be negative. Just before extubation, the anaesthesia team asked us if the OGT could be removed! To our horror, the OGT could not be pulled out on gentle tugging, confirming inclusion of the OGT in the staple line. The patient was induced again and re-explored immediately, with endoscopic guidance. Both the pouch and remnant stomach were opened, the cut ends of OGT freed from both staple lines, and the tube removed. The openings in the pouch and remnant stomach were closed with stapler. Methylene blue leak test and air insufflation test were done and found to be negative. RESULTS: Postoperative recovery was uneventful and the patient was discharged on day 5. Review of the recorded video was done but the OGT was not visualised through the initial gastrotomy as the OGT had possibly been stapled during the last vertical firing higher up near the fundus. DISCUSSION: Stapler firing over the OGT can occur insidiously without the surgeon's awareness. In this case, it was only suspected when the anaesthesia team asked us matter-of-factly whether the OGT could be removed. We had presumed that it had been removed before the first firing. Some surgeons prefer to keep the OGT for a day after surgery. Had that been our practice, this complication would have mandated a re-surgery in the early postoperative period. Such complications occur when the surgeon fails to request the anaesthesia team to remove the OGT or if there is poor communication between the surgical and anaesthesia teams. Sometimes, it can be due to change in the anaesthesia team during the procedure. In our case, though the anaesthesia team was the same, there was a new anaesthesia registrar who was involved in a bariatric surgical case for the first time. Use of transparent drapes, if available, may be advantageous, enabling the surgical team to see the OGT. The openings in the pouch and remnant stomach were closed with a stapler, as it was thought to be a more secure and faster method than oversewing. However, if the pouch is too small to allow stapler closure, simple suture closure should be done. CONCLUSION: Inclusion of orogastric tube in the staple line should be a 'never event'. This case report highlights the importance of good communication between the surgical and anaesthesia teams, not only during the staple fire, but throughout the procedure.

Postpartum depression in India: a systematic review and meta-analysis.

OBJECTIVE: To provide an estimate of the burden of postpartum depression in Indian mothers and investigate some risk factors for the condition. METHODS: We searched PubMed®, Google Scholar and Embase® databases for articles published from year 2000 up to 31 March 2016 on the prevalence of postpartum depression in Indian mothers. The search used subject headings and keywords with no language restrictions. Quality was assessed via the Newcastle-Ottawa quality assessment scale. We performed the meta-analysis using a random effects model. Subgroup analysis and meta-regression was done for heterogeneity and the Egger test was used to assess publication bias. FINDINGS: Thirty-eight studies involving 20 043 women were analysed. Studies had a high degree of heterogeneity (I2 = 96.8%) and there was evidence of publication bias (Egger bias = 2.58; 95% confidence interval, CI: 0.83-4.33). The overall pooled estimate of the prevalence of postpartum depression was 22% (95% CI: 19-25). The pooled prevalence was 19% (95% CI: 17-22) when excluding 8 studies reporting postpartum depression within 2 weeks of delivery. Small, but non-significant differences in pooled prevalence were found by mother's age, geographical location and study setting. Reported risk factors for postpartum depression included financial difficulties, presence of domestic violence, past history of psychiatric illness in mother, marital conflict, lack of support from husband and birth of a female baby. CONCLUSION: The review shows a high prevalence of postpartum depression in Indian mothers. More resources need to be allocated for capacity-building in maternal mental health care in India.

Fluoxetine for persistent developmental stuttering.

Stuttering is a disturbance in the normal fluency and time patterning of speech. Developmental stuttering (DS), with or without associated psychiatric illness, is the most common form and includes all cases with gradual onset in childhood that are not the result of acquired brain damage. Persistent developmental stuttering (PDS) is DS that has not undergone spontaneous or speech therapy-induced remission. Adults in speech therapy behavioral programs will often show regression and even total relapse if they stop practicing. This case report deals with a patient of PDS who responded significantly to treatment with fluoxetine.

Clozapine for the treatment of neurogenic bladder.

Neurogenic bladder leading to urinary incontinence has been described in patients of stroke, dementia, Parkinson's disease, and some schizophrenia cases with cognitive impairment possibly due to impaired cortical inhibition of the urinary bladder. The underlying brain abnormalities for urinary incontinence are similar in such cases. We report here such a case of neurogenic bladder responding to treatment with clozapine. The possible mechanism of action and clinical implications are described.