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In order to reduce the quality loss of citrus and extend its storage time after harvest, it is essential to develop coated kraft papers with antibacterial and fresh-keeping properties. In this study, cinnamon essential oil (CEO)/soybean protein isolate (SPI) microcapsules were prepared by the coagulation method, and their properties were optimized. Then, the microcapsules were added to konjac glucomannan (KGM) as a coating solution to enhance the physical, and chemical properties of kraft paper by a coating method. The release behavior of CEO, tensile properties, antibacterial properties and preservation effects of the paper were investigated. The results show that when the ratio of wall to core was 7:3, the highest encapsulation rate was 92.20 ± 0.43 %. The coating treatment significantly reduced the oxygen and water vapor transmission rates of kraft paper. The shelf life of citrus treated with coated Kraft was extended by >10 days. Thus, the CEO/SPI microencapsulation and KGM coating could improve the properties of kraft paper and have the potential for citrus preservation.
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BACKGROUND AIMS: Clinically significant post-endoscopic retrograde cholangiopancreatography (ERCP) bleeding (CSPEB) is common. Contemporary estimates of risk are lacking. We aimed to identify risk factors for and outcomes following CSPEB. METHODS: We analyzed multi-center prospective ERCP data between 2018-2023 with 30-day follow-up. The primary outcome was CSPEB, defined as hematemesis, melena, or hematochezia resulting in: hemoglobin drop ≥20 g/L or transfusion and/or endoscopy to evaluate suspected bleeding, and/or unplanned healthcare visitation and/or prolongation of existing admission. Firth logistic regression was employed. P-values <0.05 were significant, with odds ratios (ORs) and 95% confidence intervals reported. RESULTS: CSPEB occurred following 129 (1.5%) of 8,517 ERCPs (mean onset 3.2 days), with 110 of 4,849 events (2.3%) occurring following higher-risk interventions (sphincterotomy, sphincteroplasty, pre-cut sphincterotomy, and/or needle-knife access). CSPEB patients required endoscopy and transfusion in 86.0% and 53.5% of cases, respectively, with three cases (2.3%) being fatal. P2Y12 inhibitors were held for a median of 4 days (IQR 4) prior to higher-risk ERCP. Following higher-risk interventions, P2Y12 inhibitors (OR 3.33, 1.26-7.74), warfarin (OR 8.54, 3.32-19.81), dabigatran (OR 13.40, 2.06-59.96), rivaroxaban (OR 7.42, 3.43-15.24) and apixaban (OR 4.16, 1.99-8.20) were associated with CSPEB. Significant intraprocedural bleeding post sphincterotomy (OR 2.32, 1.06-4.60), but not post sphincteroplasty, was also associated. Concomitant cardiorespiratory events occurred more frequently within 30 days following CSPEB (OR 12.71, 4.75-32.54). CONCLUSIONS: Risks of antiplatelet-related CSPEB may be underestimated by endoscopists based on observations of suboptimal holding before higher-risk ERCP. Appropriate periprocedural antithrombotic management is essential and could represent novel quality initiative targets.
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Embolización Terapéutica , Endosonografía , Várices Esofágicas y Gástricas , Migración de Cuerpo Extraño , Arteria Pulmonar , Humanos , Embolización Terapéutica/métodos , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/instrumentación , Várices Esofágicas y Gástricas/terapia , Várices Esofágicas y Gástricas/diagnóstico por imagen , Migración de Cuerpo Extraño/diagnóstico por imagen , Arteria Pulmonar/diagnóstico por imagen , Masculino , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Persona de Mediana Edad , Ultrasonografía Intervencional , FemeninoRESUMEN
Essential oils (EOs) are liquid extracts derived from various parts of herbal or medicinal plants. They are widely accepted in food packaging due to their bioactive components, which exhibit remarkable antioxidant and antimicrobial properties against various pathogenic and food spoilage microorganisms. However, the functional efficacy of EOs is hindered by the high volatility of their bioactive compounds, leading to rapid release. Combining biopolymers with EOs forms a complex network within the polymeric matrix, reducing the volatility of EOs, controlling their release, and enhancing thermal and mechanical stability, favoring their application in food packaging or processing industries. This study presents a comprehensive overview of techniques used to encapsulate EOs, the natural polymers employed to load EOs, and the functional properties of EOs-loaded biopolymeric particles, along with their potential antioxidant and antimicrobial benefits. Additionally, a thorough discussion is provided on the widespread application of EOs-loaded biopolymers in the food industries. However, research on their utilization in confectionery processing, such as biscuits, chocolates, and others, remains limited. Further studies can be conducted to explore and expand the applications of EOs-loaded biopolymeric particles in food processing industries.
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Antiinfecciosos , Aceites Volátiles , Aceites Volátiles/farmacología , Antioxidantes/farmacología , Industria de Procesamiento de Alimentos , Embalaje de Alimentos/métodos , Biopolímeros , Polímeros , Industria de AlimentosRESUMEN
BACKGROUND AND AIMS: Resection of colorectal polyps has been shown to decrease the incidence and mortality of colorectal cancer. Large nonpedunculated colorectal polyps are often referred to expert centers for endoscopic resection, which requires relevant information to be conveyed to the therapeutic endoscopist to allow for triage and planning of resection technique. The primary objective of this study was to establish minimum expected standards for the referral of large nonpedunculated colonic polyps for potential endoscopic resection. METHODS: A Delphi method was used to establish consensus on minimum expected standards for the referral of large colorectal polyps among a panel of international endoscopy experts. The expert panel was recruited through purposive sampling, and 3 rounds of surveys were conducted to achieve consensus. Quantitative and qualitative data were analyzed for each round. RESULTS: A total of 24 international experts from diverse continents participated in the Delphi study, resulting in consensus on 19 statements related to the referral of large colorectal polyps. The identified factors, including patient demographic characteristics, relevant medications, lesion factors, photodocumentation, and the presence of a tattoo, were deemed important for conveying the necessary information to therapeutic endoscopists. The mean scores for the statements, which were scored on a scale of 1 to 10, ranged from 7.04 to 9.29, with high percentages of experts considering most statements as a very high priority. Subgroup analysis according to continent revealed some variations in consensus rates among experts from different regions. CONCLUSIONS: The identified consensus statements can aid in improving the triage and planning of resection techniques for large colorectal polyps, ultimately contributing to the reduction of colorectal cancer incidence and mortality.
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Pólipos del Colon , Colonoscopía , Consenso , Técnica Delphi , Derivación y Consulta , Humanos , Pólipos del Colon/cirugía , Pólipos del Colon/patología , Derivación y Consulta/normas , Colonoscopía/normas , Neoplasias Colorrectales/cirugía , Neoplasias Colorrectales/patologíaRESUMEN
Rhizosphere is a soil volume of high spatio-temporal heterogeneity and intensive plant-soil-microbial interactions, for which visualization and process quantification is of highest scientific and applied relevance, but still very challenging. A novel methodology for quick assessment of two-dimensional distribution of available phosphorus (P) in rhizosphere was suggested, tested, and development up to the application platform. Available P was firstly trapped by an in-situ diffusive gradients in thin-films (DGT) sampler with precipitated zirconia as the binding gel, and subsequently, the loaded gel was analyzed with an optimized colorimetric imaging densitometry (CID). The imaging platform was established linking: i) DGT, ii) planar optode, and iii) soil zymography techniques to simultaneously determine available P, oxygen, and acid phosphatase in rhizosphere at sub-millimeter spatial scales. The DGT identified available P level in rice rhizosphere were spatially overlapping to the localized redox hotspots and phosphatase activity. The spatial relationship between available P and acid phosphatase activity was dependent on root development. The root radial oxygen loss (ROL) remained active during the experimental observations (2-3 days), while a flux of available P of 10 pg cm-2 s-1 was visualized within 2-3 mm of roots, confirming the correlative response of rice roots to oxygen secretion and P uptake. Summarizing, the established imaging platform is suitable to capture spatial heterogeneity and temporal dynamics of root activities, nutrient bioavailability, ROL and enzyme activities in rhizosphere.
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Oryza , Fósforo , Fósforo/metabolismo , Rizosfera , Suelo , Oxígeno/metabolismo , Fosfatasa Ácida/metabolismo , Raíces de Plantas/metabolismoRESUMEN
BACKGROUND AND AIMS: The incidence, risk factors, and outcomes of post-ERCP cholecystitis are poorly described. We aimed to describe cases of post-ERCP cholecystitis from a prospective multicenter registry with protocolized 30-day follow-up. METHODS: Patient- and procedure-related data from 7 centers were obtained. The primary outcome was post-ERCP cholecystitis, defined according to a Delphi-based criteria and causal attribution system. Risk factors and outcomes were described for all cases. RESULTS: Seventeen cases of post-ERCP cholecystitis were identified among 4428 patients with gallbladders undergoing ERCP between 2018 and 2023 (incidence, 0.38%; 95% confidence interval, 0.20-0.57). In ERCPs with covered metal stenting, 7 of 467 resulted in cholecystitis (incidence, 1.50%; 95% confidence interval, 0.40-2.60). Patients had symptoms at a median of 5 days (interquartile range, 5) after ERCP. Management strategies included cholecystectomy, percutaneous cholecystostomy, and endoscopic stent removal/exchange. CONCLUSIONS: Estimates of post-ERCP cholecystitis incidence can inform discussions around procedural risk.
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Sistema Biliar , Colecistitis , Humanos , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Colecistitis/epidemiología , Colecistitis/etiología , Incidencia , Estudios Prospectivos , Estudios Retrospectivos , Estudios Multicéntricos como AsuntoRESUMEN
For image-based computational fluid dynamics (CFD) analysis to characterize the local coronary hemodynamic environment, the accuracy depends on the flow rate which is in turn associated with outlet branches' morphology. A good flow distribution strategy is important to mitigate the effect when certain branches cannot be considered. In this study, stenotic coronary arteries from 13 patients were used to analyze the effect of missing branches and different flow distribution strategies. Pressure- and wall shear stress (WSS)-derived parameters around the stenotic region (ROI) were compared, including fractional flow reserve (CT-FFR), instantaneous wave-free ratio (CT-iFR), resting distal to aortic coronary pressure (CT-Pd/Pa), time-averaged WSS, oscillatory shear index (OSI) and relative residence time (RRT). Three flow distribution strategies were the Huo-Kassab model at distal outlets (Type I), flow distribution based on outlet resistances (Type II), and a developed algorithm distributing flow at each bifurcation until the final outlets (Type III). Results showed that Type III strategy for models with truncated branch(es) had a good agreement in both pressure- and WSS-related results (interquatile range less than 0.12% and 4.02%, respectively) with the baseline model around the ROI. The relative difference of pressure- and WSS-related results were correlated with the flow differences in the ROI to the baseline mode. Type III strategy had the best performance in maintaining the flow in intermediate branches. It is recommended for CFD analysis. Removal of branches distal to a stenosis can be undertaken with an improved performance and maintained accuracy, while those proximal to the ROI should be kept.
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Estenosis Coronaria , Reserva del Flujo Fraccional Miocárdico , Humanos , Vasos Coronarios , Estenosis Coronaria/diagnóstico por imagen , Hidrodinámica , Corazón , Hemodinámica , Angiografía CoronariaRESUMEN
Background: Esophageal cancer is one of the most unknown and deadliest cancers in the world. Although recent studies have identified some mutations linked to the development of squamous cell carcinoma of the esophagus (ESCC), the specific role of HomeoboxC10 (HOXC10) in the pathogenesis still requires further investigation. Methods: Agilent mRNA single-channel gene expression was employed to identify genome-wide gene signatures in ESCC. These signatures were also verified using qRT-PCR, immunohistochemical staining as well as Western blot. The biological functions of HOXC10 were further investigated through cellular studies conducted on ESCC cells. Survival analysis was conducted utilizing the Kaplan-Meier method. The GEPIA database and the STRING website were utilized to predict the potential targets that bind to HOXC10. Co-immunoprecipitation assays were performed to investigate the binding interaction between HOXC10 and Forkhead Box A3 (FOXA3). Animal models were established to analyze the effects of HOXC10 silencing on tumorigenesis in vivo. Results: The expression levels of HOXC10 mRNA were found to be upregulated in ESCC. Survival analysis revealed a significant association between abnormally elevated levels of HOXC10 mRNA and an unfavorable prognosis in patients with ESCC. In vitro studies revealed that the knockdown of HOXC10 expression resulted in the inhibition of the proliferation, invasion, and migrating ability of ESCC cells through the upregulation of FOXA3. Furthermore, tumor-bearing mouse models studies demonstrated that HOXC10 through knockdown techniques significantly suppressed ESCC tumor growth. HOXC10 was found to enhance the activation of the MAPK signaling pathway by regulating FOXA3 in ESCC cells. Conclusion: These results support a key role for HOXC10 in the tumorigenesis of ESCC by upregulating FOXA3 via the MAPK pathway and highlight its potential as a promising diagnostic and prognostic marker for ESCC.
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Background: Barrett's esophagus (BE) is a premalignant condition to esophageal adenocarcinoma (EAC). Low socioeconomic (SES) status adversely impacts care and outcomes in patients with EAC, but this has not been evaluated in BE. As the treatment of BE is similarly intensive, we aimed to evaluate the effect of SES on achieving complete eradication of intestinal metaplasia (CE-IM), dysplasia (CE-D) and development of invasive EAC. Methods: Our study was a retrospective cohort study. Consecutive patients between January 1, 2010, to December 31, 2018, referred for BE-associated high-grade dysplasia or intramucosal adenocarcinoma were included. Pre, intra and post-procedural data were collected. Household income data was collected from the 2016 census based on postal code region. Patients were divided into income groups relative to the 2016 median household income in Ontario. Multivariate regression was performed for outcomes of interest. Results: Four hundred and fifty-nine patients were included. Rate of CE-IM was similar between income groups. Fifty-five per cent (n = 144/264) versus 65% (n = 48/264) in the below and above-income groups achieved CE-D, respectively, P = 0.02. Eighteen per cent (n = 48/264) versus 11% (n = 22/195) were found to have invasive EAC during their treatment course in below and above-income groups, respectively, P = 0.04. Residing in a below-median-income district was associated with developing invasive EAC (Odds Ratio, [OR] 1.84, 95% confidence interval [CI] 1.01 to 3.35) and failure to achieve CE-D (OR 0.64, 95% CI 0.42 to 0.97). Conclusions: Residing in low-income districts is associated with worse outcomes in patients with advanced BE. Further research is needed to guide future initiatives to address the potential impact of SES barriers in the optimal care of BE.
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BACKGROUND: Gallstone disease poses a significant health burden in the United States. Choledocholithiasis and cholangitis are common complications of gallstone disease for which data on current epidemiological trends are lacking. We aimed to evaluate temporal changes in hospitalization, management, and outcomes for patients with choledocholithiasis and cholangitis. METHODS: The National Inpatient Sample was used to identify discharges for choledocholithiasis and cholangitis between 2005 and 2014. Temporal trends were evaluated via annual percent changes (APCs). Joinpoint regression was used to assess inflection points. Multivariable regression models were used to evaluate associations of interest. RESULTS: From 189,362 unweighted discharges for choledocholithiasis and/or cholangitis, there was an increase in discharges for choledocholithiasis (APC 2.3%, 95% confidence intervals, CI, 1.9-2.7%) and cholangitis (APC 1.5%, 95% CI 0.7-2.2%). Procedural interventions were more likely at urban hospitals for choledocholithiasis (adjusted odds ratio, aOR, 2.94, 95% CI 2.72 to 3.17) and cholangitis (aOR 2.97, 95% CI 2.50 to 3.54). In-hospital mortality significantly decreased annually for choledocholithiasis (aOR 0.90, 95% CI 0.88 to 0.93) and cholangitis (aOR 0.93, 95% CI 0.89 to 0.97). In-hospital mortality between rural and urban centers was comparable for choledocholithiasis (aOR 1.16, 95% CI 0.89 to 1.52) and cholangitis (aOR 1.12, 95% CI 0.72 to 1.72). CONCLUSIONS: Hospitalizations for choledocholithiasis and cholangitis have increased between 2005 and 2014, reflecting a growing burden of gallstone disease. Hospital mortality between urban and rural centers is similar, however urban centers have a higher rate of procedural interventions suggesting limitations to accessing procedural interventions at rural centers.
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Colangitis , Coledocolitiasis , Humanos , Estados Unidos/epidemiología , Coledocolitiasis/epidemiología , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Colangitis/etiología , Hospitalización , Población Rural , Estudios RetrospectivosRESUMEN
Nanofibrous composite membranes consisting of polyvinyl alcohol (PVA), sodium alginate (SA), chitosan-nano zinc oxide nanoparticles (CS-Nano-ZnO) and curcumin (Cur) were prepared by ultrasonic processing and electrospinning. When the ultrasonic power was set to 100 W, the prepared CS-Nano-ZnO had a minimum size (404.67 ± 42.35 nm) and a generally uniform particle size distribution (PDI = 0.32 ± 0.10). The composite fiber membrane with Cur: CS-Nano-ZnO mass ratio of 5:5 exhibited the best water vapor permeability, strain and stress. Furthermore, the inhibitory rates against Escherichia coli and Staphylococcus aureus were 91.93 ± 2.07 % and 93.00 ± 0.83 %, respectively. The Kyoho grape fresh-keeping trial revealed that grape berries wrapped with composite fiber membrane still maintained good quality and a higher rate of good fruit (60.25 ± 1.46 %) after 12 days of storage. The shelf life of grape was extended by at least 4 days. Thus, nanofibrous composite membranes based on CS-Nano-ZnO and Cur was expected to be used as an active material for food packaging.
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Quitosano , Curcumina , Nanofibras , Vitis , Óxido de Zinc , Óxido de Zinc/farmacología , Antibacterianos/farmacología , Quitosano/farmacología , Curcumina/farmacologíaRESUMEN
Background: Endoscopic submucosal dissection (ESD) has become an established standard for endoscopic removal of large gastrointestinal (GI) lesions and early GI malignancies. However, ESD is technically challenging and requires significant health care infrastructure. As such, its adoption in Canada has been relatively slow. The practice of ESD across Canada remains unclear. Our study aimed to provide a descriptive overview of training pathways and practice trends of ESD in Canada. Methods: Current ESD practitioners across Canada were identified and invited to participate in an anonymous cross-sectional survey. Results: Twenty-seven ESD practitioners were identified; survey response rate was 74%. Respondents were from 15 different institutions. All practitioners underwent international ESD training of some type. Fifty per cent pursued long-term ESD training programs. Ninety-five per cent attended short-term training courses. Sixty per cent and 40% performed hands-on live human upper and lower GI ESD, respectively, before independent practice. In practice, 70% saw an increase per year in number of procedures performed from 2015 to 2019. Sixty per cent were dissatisfied with their institution's health care infrastructure to support ESD. Thirty-five per cent perceived their institution as supportive of expanding the practice of ESD. Conclusions: Several challenges exist to the adoption of ESD in Canada. Training pathways are variable, with no set standards. In practice, practitioners express dissatisfaction with access to necessary infrastructure and feel poorly supported in expanding the practice of ESD. As ESD is increasingly the accepted standard for the treatment of many neoplastic GI lesions, greater collaboration between practitioners and institutions is crucial to standardize training and ensure patient access.
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BACKGROUND: Despite post-ERCP pancreatitis (PEP) being a major focus of outcomes research in endoscopic retrograde cholangiopancreatography (ERCP), little is known regarding the frequency with which asymptomatic biochemical and/or radiologic pancreatic alterations occur in patients following ERCP. METHODS: Adult inpatients undergoing ERCP were identified from a prospective ERCP registry. Patients with any abdominal pain, confirmed PEP, or pancreatitis or abnormal pancreatic enzymes preceding ERCP were excluded. Primary outcomes were asymptomatic lipase elevation on bloodwork within 24 h of ERCP or asymptomatic cross-sectional imaging findings consistent with acute pancreatitis in the absence of clinical PEP within 14 days. Multinomial logistic regression and multiple logistic regression were used to examine associations between exposures and lipase levels and between PEP or imaging findings, respectively. RESULTS: In total, 646 and 187 patients were analyzed as part of the biochemical and radiologic cohorts, respectively. A total of 26.0% of patients had asymptomatic elevations in lipase above the upper limit of normal (ULN) within 24 h, and 9.4% had elevations >3× ULN. A total of 20.9% of patients had incidental findings of enlargement, inflammation/edema/fat stranding, peri-pancreatic fluid collections, and/or necrosis on cross-sectional imaging within 14 days. Pancreatic contrast injection was associated with higher odds of asymptomatic lipasemia (adjusted odds ratio, AOR, 7.22; 95% confidence intervals, CI, 1.13 to 46.02), as was the use of the double-wire technique (AOR 15.74; 95% 1.15 to 214.74) and placement of a common bile duct stent (AOR 4.19; 95% CI 1.37 to 12.77). Over 10 cannulation attempts were associated with the presence of one or more radiologic finding(s) (AOR 33.95; 95% CI 1.64, to 704.13). CONCLUSIONS: Significant rates of incidental biochemical and/or radiologic pancreatic abnormalities are present following ERCP. Clinicians should be aware of our findings to minimize misclassification and better direct healthcare utilization.
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Aging is one of the key mechanisms of vascular dysfunction and contributes to the initiation and progression of ischemic stroke (IS). Our previous study demonstrated that ACE2 priming enhanced the protective effects of exosomes derived from endothelial progenitor cells (EPC-EXs) on hypoxia-induced injury in aging endothelial cells (ECs). Here, we aimed to investigate whether ACE2-enriched EPC-EXs (ACE2-EPC-EXs) could attenuate brain ischemic injury by inhibiting cerebral EC damage through their carried miR-17-5p and the underlying molecular mechanisms. The enriched miRs in ACE2-EPC-EXs were screened using the miR sequencing method. EPC-EXs, ACE2-EPC-EXs, and ACE2-EPC-EXs with miR-17-5p deficiency (ACE2-EPC-EXsantagomiR-17-5p) were administered to transient middle cerebral artery occlusion (tMCAO)-operated aged mice or coincubated with hypoxia/reoxygenation (H/R)-treated aging ECs. The results showed that (1) the level of brain EPC-EXs and their carried ACE2 were significantly decreased in aged mice compared to in young mice, and (2) after tMCAO, aged mice displayed increases in brain cell senescence, infarct volume, and neurological deficit score (NDS) and a decrease in cerebral blood flow (CBF). (3) Compared with EPC-EXs, ACE2-EPC-EXs were enriched with miR-17-5p and more effective in increasing ACE2 and miR-17-5p expression in cerebral microvessels, accompanied by obvious increases in cerebral microvascular density (cMVD) and cerebral blood flow (CBF) and decreases in brain cell senescence, infarct volume, neurological deficit score (NDS), cerebral EC ROS production, and apoptosis in tMCAO-operated aged mice. Moreover, silencing of miR-17-5p partially abolished the beneficial effects of ACE2-EPC-EXs. (4) In H/R-treated aging ECs, ACE2-EPC-EXs were more effective than EPC-EXs in decreasing cell senescence, ROS production, and apoptosis and increasing cell viability and tube formation. In a mechanistic study, ACE2-EPC-EXs more effectively inhibited PTEN protein expression and increased the phosphorylation of PI3K and Akt, which were partially abolished by miR-17-5p knockdown. Altogether, our data suggest that ACE-EPC-EXs have better protective effects on ameliorating aged IS mouse brain neurovascular injury by inhibiting cell senescence, EC oxidative stress, apoptosis, and dysfunction by activating the miR-17-5p/PTEN/PI3K/Akt signaling pathway.
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Lesiones Encefálicas , Células Progenitoras Endoteliales , Exosomas , MicroARNs , Ratones , Animales , Células Progenitoras Endoteliales/metabolismo , MicroARNs/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Enzima Convertidora de Angiotensina 2/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Exosomas/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Lesiones Encefálicas/metabolismo , Hipoxia/metabolismo , Infarto/metabolismo , ApoptosisRESUMEN
BACKGROUND: Gallstone disease remains a major health issue. There have been significant changes in the management and demographics of patients with these conditions. We aimed to evaluate trends in hospitalization, management, and post-procedural adverse events for patients with gallstone disease. METHODS: The National Inpatient Sample was used to identify discharges for symptomatic cholelithiasis and cholecystitis between 2005 and 2014. Temporal trends were evaluated by calculating annual percent changes (APCs). Joinpoint regression was used to assess inflection points. Multivariable regression models were used to evaluate associations between urban and rural divisions and mortality, use of interventional procedures, and post-procedural adverse events. RESULTS: From 77,394,755 unweighted discharges, there was a decline in discharges for cholelithiasis (APC - 5.5%, 95% confidence intervals, CI, - 7.6 to - 3.4%) and cholecystitis from 2012 to 2014 (APC - 4.5%, 95% CI - 7.2 to - 1.7%). Interventions were more likely at urban hospitals for symptomatic cholelithiasis (odds ratio, OR, 1.49, 95% CI 1.24 to 1.66) and cholecystitis (OR 1.96, 95% CI 1.86 to 2.05). In-hospital mortality significantly decreased annually for patients with cholecystitis (OR 0.92, 95% CI 0.91 to 0.93). In-hospital mortality between rural and urban centers was comparable for symptomatic cholelithiasis (OR 1.27, 95% CI 0.79 to 2.03) and cholecystitis (OR 0.93, 95% CI 0.84 to 1.04). CONCLUSIONS: Hospitalizations for gallstone disease have decreased since the 2010s. In-hospital mortality between urban and rural centers is similar, but urban hospitals utilize a higher rate of procedural interventions. Future studies should evaluate practice trends and costs across inpatient and ambulatory settings between rural and urban divisions.
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Colecistitis , Colelitiasis , Humanos , Colelitiasis/epidemiología , Colelitiasis/cirugía , Colecistitis/epidemiología , Colecistitis/cirugía , HospitalizaciónRESUMEN
Over a few decades, anthocyanin (ACN)-based colorimetric indicators in intelligent packaging systems have been widely used to monitor the freshness or spoilage of perishable food products. Most of the perishable food products are highly susceptible to enzymatic/microbial spoilage and produce several volatile or nonvolatile organic acid and nitrogenous compounds. As a result, the natural pH of fresh foods significantly changes. Fabrication of CAN-based colorimetric indicators in intelligent packaging systems is an advanced technique that monitors the freshness or spoilage of perishable foods based on the display of color variations at varying pH values. This study focuses on the advancement of pH-sensitive indicators and extraction of colorimetric indicators from commercially available natural sources. Moreover, the fabrication techniques and widespread industrial applications of such indicators have also been discussed. In addition, readers will get information about the color-changing and antioxidant mechanisms of ACN-based indicator films in food packaging.
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Embalaje de Alimentos , Alimentos , Embalaje de Alimentos/métodos , Calidad de los Alimentos , Concentración de Iones de Hidrógeno , Antocianinas/químicaRESUMEN
In this study, lemongrass essential oil (LEO) was wrapped in ß-cyclodextrin (ß-CD) using a co-precipitation method to prepare an inclusion complex (LEO/ß-CD). A biological multifunctional preservation card was prepared by 3D printing and mixing the inclusion complex with sodium alginate (SA). The moisture generated by strawberry respiration melted the popping candy (PPC) and stimulated the release of CO2, a synergistic antibacterial compound formed with LEO. Hence, antibacterial activity and air regulation were achieved, and the fruit remained fresh. The results indicated that LEO was successfully encapsulated in ß-CD, and that LEO/ß-CD had a strong bacteriostatic effect on Aspergillus niger and Botrytis cinerea, with a high resistance to oxidation. The PPC could release CO2 and extend the shelf life of strawberries by reducing their respiration and inhibiting mold.
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Fragaria , Aceites Volátiles , beta-Ciclodextrinas , Alginatos/farmacología , Antibacterianos , Atmósfera , Dulces , Dióxido de Carbono , Aceites Volátiles/farmacología , Impresión TridimensionalRESUMEN
Rock-bean protein (RP) was extracted from wild rock beans by ultrasonic treatment and microwave extraction. The RP has a high content of 7S and 11S globulin components and good heat stability. Subsequently, water-oil-water double emulsions were prepared using a water core containing nisin, momordica charantia extract (MCE), and Lactobacillus plantarum as functional additives, corn oil as the intermediate wall, and RP/gum arabic (GA) as the outer wall material. For a ratio of corn oil to water of 5:1, the maximum encapsulation efficiency was 28.22%, and RP/GA had good dispersion characteristics, where the smallest average particle size was achieved for a 1:1 ratio. Finally, the microcapsules were used to study the effect of its addition to noodles. The addition of 2 wt% of the microcapsules to low-gluten flour resulted in a dough with suitable rheology, and can extend the shelf life of the fresh noodles prepared using this dough.
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Background: Endoscopic retrograde cholangiopancreatography (ERCP) brush cytology is used frequently for sampling indeterminate biliary strictures. Studies have demonstrated that the diagnostic yield of brush cytology for malignant strictures is estimated to be 6%-70%. With improved diagnostic tools, sampling techniques and specimen processing, the yield of ERCP brush cytology may be higher. This study aimed to assess the yield of brush cytology and determine factors associated with a positive diagnosis. Methods: This was a cohort study of patients who underwent ERCP brush cytology from October 2017 to May 2020. Patient demographics, clinical, procedural and pathological data were collected using chart review. Sampling data were captured up to 3 months post-index ERCP to capture repeat brushings, biopsies or surgical resections. Outcomes included the diagnostic yield, true/false positive values and true/false negative values of malignancy detection using ERCP brush cytology. Results: A total of 126 patients underwent a brush cytology, 58% were male and 79% had a stricture in the extrahepatic region. Ninety-three patients were diagnosed with a malignancy, of which 78 had positive brush cytology results and 15 had a negative brush cytology result. The diagnostic yield, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 84%, 83%, 97%, 99%, 68% and 87% respectively. Conclusion: ERCP brush cytology performed using updated sampling technique is associated with high diagnostic yield. This allows for earlier malignancy diagnosis, timely treatment and decreased need for further investigation.