Evaluation of physicochemical and functional properties of spray-dried protein hydrolysate from non-penaeid shrimp (Acetes indicus).

BACKGROUND: Protein hydrolysate powder was prepared from non-penaeid shrimp (Acetes indicus) by enzymatic hydrolysis using Alcalase enzyme. Extraction conditions such as pH (6.5, 7.5 and 8.5), enzyme to substrate ratio (1.0, 1.5 and 2.0) and temperature (40, 50 and 60 °C) were optimized against the degree of hydrolysis using response surface methodology. RESULTS: Protein hydrolysate comprised of 740 g kg-1 protein, 150 g kg-1 ash and 90 g kg-1 fat contents. The amino acid score showed superior attributes with 56% essential amino acids. Furthermore, the functional properties of spray-dried protein hydrolysates were evaluated. Protein solubility was found to be the 90.20% at pH 2 and 96.92% at pH 12. Emulsifying properties were found to vary with the concentration of protein hydrolysates and the highest emulsifying capacity (26.67%) and emulsion stability (23.33%) were found at a concentration of 20 mg mL-1 . The highest and the lowest foaming capacity were observed at pH 6 and pH 10 with a concentration of 20 mg mL-1 . The water holding capacity of protein hydrolysate was found to increase with concentration, with a value of 5.4 mL g-1 at a concentration of 20 mg mL-1 . CONCLUSION: The results of the present study indicate that the use of A. indicus for the production of protein hydrolysate has good functional properties and nutritional value, rendering it suitable for broad industrial food applications. © 2019 Society of Chemical Industry.

Identifying and selecting new procedures for health technology assessment: a decade of nice experience in the United Kingdom.

OBJECTIVES: The aim of this study was to analyze the experience of the National Institute for Health and Care Excellence (NICE) in identifying new procedures entering the United Kingdom (UK) healthcare system, for assessment and publication of recommendations on their use. This system is designed to provide guidance in an area where regulation is lacking worldwide. METHODS: Retrospective analysis of all procedures notified to the Interventional Procedures Programme (NICE) between 2002 and 2012. Notifications were analyzed year by year for their source (who notified them), clinical specialties involved, and whether guidance was subsequently published. RESULTS: A total of 1,094 procedures were notified by clinicians (51 percent), and by others, including hospitals (6 percent), horizon scanners (5 percent), patients (4 percent), private health insurers (4 percent), and medical device manufacturers (3 percent). Guidance was published on 44 percent of procedures notified to the program. There was a decrease in the numbers of procedures notified during 2003-2012 (p = .049). There were notifications across all specialties, with the largest numbers in general surgery (125), urology (104), orthopedics (99), interventional radiology (93), cardiology (82), and obstetrics and gynecology (82). CONCLUSIONS: The "open" NICE Web portal allows anyone to notify new procedures, aiming to maximize the opportunity of identifying all those procedures entering clinical practice. This has resulted in identification of large numbers of procedures from across the whole range of medical specialties. The fact that similar proportions of procedures notified from diverse sources have been selected for assessment and publication of practice recommendations suggests that this inclusive approach is worthwhile.

Process optimization and evaluation of the effects of different time-temperature sous vide cooking on physicochemical, textural, and sensory characteristics of whiteleg shrimp (Litopenaeusvannamei).

The objective of the current study was to optimize the cook-chill conditions of high-value whiteleg shrimp (Litopenaeus vannamei) processed using the sous vide (SV) technique and to assess the effects of various time-temperature combinations on the physicochemical, textural, and sensory qualities. For optimization, a Response Surface Methodology (RSM) approach utilizing a Central Composite Design (CCD) was adopted. Optimum SV cooking conditions to acquire minimum texture (hardness) of 7235 g was 13.48 min and 81.87 °C, expressible moisture of 18.48% was 14.5 min and 84.5 °C, and cook loss of 5.58% was 5 min and 75 °C. Texture (hardness) and expressible moisture decreased while cooking loss increased with increasing time-temperature treatment. Redness and yellowness values increased (p < 0.05) with increasing SV cooking time-temperature, but lightness values were nearly consistent in all treatments. With increasing time and temperature, TBARs and total carotenoid content increased (p < 0.05). However, the TBARs values were within accepted limits and ranged from 0.05 to 0.08 mg malonaldehyde/kg. Sensory evaluation indicated that all SV cooked samples were well accepted, with overall scores ≥7. These results suggest that the SV cooking temperature and time had a substantial impact on the textural, physicochemical, and sensory characteristics of shrimp. In addition, increasing time-temperature increased cooking and moisture loss, but decreased hardness and higher sensory scores made the product more acceptable to consumers.

Cost-effectiveness of multi-component interventions to prevent delirium in older people admitted to medical wards.

INTRODUCTION: there is evidence to suggest that delirium incidence can be reduced in older people admitted to medical services using multi-component interventions that target delirium risk factors. The cost-effectiveness of this approach is uncertain. We therefore developed a novel cost-effectiveness model for delirium prevention. METHOD: we compared multi-component delirium prevention intervention with usual care using a model based on a decision tree analysis. The model was used to estimate the incremental net monetary benefit (INMB). The robustness of the cost-effectiveness result was explored using deterministic and probabilistic sensitivity analyses. RESULT: the multi-component prevention intervention was cost-effective when compared with usual care. It was associated with an INMB of £2,200 using a cost-effectiveness threshold of £20,000 per quality-adjusted life year (QALY). It remained cost-effective in the majority of the deterministic sensitivity analyses and was cost-effective in 96.8% of the simulations carried out in the probabilistic sensitivity analysis. DISCUSSION: our analysis has shown convincingly that multi-component prevention interventions for delirium should be considered as a cost-effective health-care strategy for medically ill people admitted to hospital. It is an attractive intervention for health-care planners as they strive to reconfigure their services to better meet the needs of an ageing population.

Interventions to improve the use of systematic reviews in decision-making by health system managers, policy makers and clinicians.

BACKGROUND: Systematic reviews provide a transparent and robust summary of existing research. However, health system managers, national and local policy makers and healthcare professionals can face several obstacles when attempting to utilise this evidence. These include constraints operating within the health system, dealing with a large volume of research evidence and difficulties in adapting evidence from systematic reviews so that it is locally relevant. In an attempt to increase the use of systematic review evidence in decision-making a number of interventions have been developed. These include summaries of systematic review evidence that are designed to improve the accessibility of the findings of systematic reviews (often referred to as information products) and changes to organisational structures, such as employing specialist groups to synthesise the evidence to inform local decision-making. OBJECTIVES: To identify and assess the effects of information products based on the findings of systematic review evidence and organisational supports and processes designed to support the uptake of systematic review evidence by health system managers, policy makers and healthcare professionals. SEARCH METHODS: We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, Web of Science, and Health Economic Evaluations Database. We also handsearched two journals (Implementation Science and Evidence and Policy), Cochrane Colloquium abstracts, websites of key organisations and reference lists of studies considered for inclusion. Searches were run from 1992 to March 2011 on all databases, an update search to March 2012 was run on MEDLINE only. SELECTION CRITERIA: Randomised controlled trials (RCTs), interrupted time-series (ITS) and controlled before-after studies (CBA) of interventions designed to aid the use of systematic reviews in healthcare decision-making were considered. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted the data and assessed the study quality. We extracted the median value across similar outcomes for each study and reported the range of values for each median value. We calculated the median of the two middlemost values if an even number of outcomes were reported. MAIN RESULTS: We included eight studies evaluating the effectiveness of different interventions designed to support the uptake of systematic review evidence. The overall quality of the evidence was very low to moderate.Two cluster RCTs evaluated the effectiveness of multifaceted interventions, which contained access to systematic reviews relevant to reproductive health, to change obstetric care; the high baseline performance in some of the key clinical indicators limited the findings of these studies. There were no statistically significant effects on clinical practice for all but one of the clinical indicators in selected obstetric units in Thailand (median effect size 4.2%, range -11.2% to 18.2%) and none in Mexico (median effect size 3.5%, range 0.1% to 19.0%). In the second cluster RCT there were no statistically significant differences in selected obstetric units in the UK (median effect RR 0.92; range RR 0.57 to RR 1.10). One RCT evaluated the perceived understanding and ease of use of summary of findings tables in Cochrane Reviews. The median effect of the differences in responses for the acceptability of including summary of findings tables in Cochrane Reviews versus not including them was 16%, range 1% to 28%. One RCT evaluated the effect of an analgesic league table, derived from systematic review evidence, and there was no statistically significant effect on self-reported pain. Only one RCT evaluated an organisational intervention (which included a knowledge broker, access to a repository of systematic reviews and provision of tailored messages), and reported no statistically significant difference in evidence informed programme planning.Three interrupted time series studies evaluated the dissemination of printed bulletins based on evidence from systematic reviews. A statistically significant reduction in the rates of surgery for glue ear in children under 10 years (mean annual decline of -10.1%; 95% CI -7.9 to -12.3) and in children under 15 years (quarterly reduction -0.044; 95% CI -0.080 to -0.011) was reported. The distribution to general practitioners of a bulletin on the treatment of depression was associated with a statistically significant lower prescribing rate each quarter than that predicted by the rates of prescribing observed before the distribution of the bulletin (8.2%; P = 0.005). AUTHORS' CONCLUSIONS: Mass mailing a printed bulletin which summarises systematic review evidence may improve evidence-based practice when there is a single clear message, if the change is relatively simple to accomplish, and there is a growing awareness by users of the evidence that a change in practice is required. If the intention is to develop awareness and knowledge of systematic review evidence, and the skills for implementing this evidence, a multifaceted intervention that addresses each of these aims may be required, though there is insufficient evidence to support this approach.

Synopsis of the National Institute for Health and Clinical Excellence guideline for prevention of delirium.

DESCRIPTION: Delirium is common, is often underrecognized, and is associated with poor outcomes and high costs. In July 2010, the National Institute for Health and Clinical Excellence released a guideline that addressed diagnosis, prevention, and management of delirium. This synopsis focuses on the main recommendations about prevention of delirium. METHODS: The National Clinical Guideline Centre developed these guidelines by using standard methodology of the National Institute for Health and Clinical Excellence. A multidisciplinary guideline development group posed review questions, discussed evidence, and formulated the recommendations. To underpin the guideline, a technical team from the National Clinical Guideline Centre systematically reviewed and graded pertinent evidence identified from literature searches of studies published in English to August 2009 and performed health economic modeling. Stakeholder and public comment informed guideline development and modifications. RECOMMENDATIONS: Considering prevention a feasible and cost-effective health strategy, the guideline development group made 13 specific recommendations that addressed the stability of the care environment (both the care team and location) and the provision of a multicomponent intervention package tailored for persons at risk for delirium. The multicomponent intervention package included assessment and modification of key clinical factors that may precipitate delirium, including cognitive impairment or disorientation, dehydration or constipation, hypoxia, infection, immobility or limited mobility, several medications, pain, poor nutrition, sensory impairment, and sleep disturbance.

Methods and Benefits of Measuring Human-Centered Design in Global Health.

Monitoring and evaluation (M&E), a new frontier for human-centered design (HCD), is still largely unexplored. In global health, M&E is considered essential to good practice, and evidence and data are critical tools in program design, performance monitoring, impact evaluation, and adaptation and learning. As HCD is increasingly integrated into global health practice, designers and global health practitioners are learning as they go how to integrate measurement into design and adapt traditional M&E approaches to design-influenced global health projects. This article illustrates some of the tensions inherent in the way global health and HCD practitioners approach measurement, using several cases to illustrate the ways in which tensions can be managed. Using framing introduced by the MeasureD project, which aimed to audit measurement practices in HCD (called social design in the MeasureD project), we explore 3 recent examples of design-influenced global health interventions: 1 focusing on products, 1 on behavior change, and 1 on service improvement, to extract learning about how teams used measurement, for what purpose, and to what effect. In comparing these examples and recent experience, we report on the steps being taken toward greater alignment in the use of measurement to advance human-centered global health programming.

Opposite Polarity Surface Photovoltage of MoS2 Monolayers on Au Nanodot versus Nanohole Arrays.

We prepared MoS2 monolayers on Au nanodot (ND) and nanohole (NH) arrays. Both these sample arrays exhibited enhanced photoluminescence intensity compared with that of a bare SiO2/Si substrate. The reflectance spectra of MoS2/ND and MoS2/NH had clear features originating from excitation of localized surface plasmon and propagating surface plasmon polaritons. Notably, the surface photovoltages (SPV) of these hybrid plasmonic nanostructures had opposite polarities, indicating negative and positive charging at MoS2/ND and MoS2/NH, respectively. Surface potential maps, obtained by Kelvin probe force microscopy, suggested that the potential gradient led to a distinct spatial distribution of photo-generated charges in these two samples under illumination. Furthermore, the local density of photo-generated excitons, as predicted from optical simulations, explained the SPV spectra of MoS2/ND and MoS2/NH. We show that the geometric configuration of the plasmonic nanostructures modified the polarity of photo-generated excess charges in MoS2. These findings point to a useful means of optimizing optoelectronic characteristics and improving the performance of MoS2-based plasmonic devices.

Rheological properties of washed and unwashed tilapia (Oreochromis mossambicus) fish meat: effect of sucrose and sorbitol.

In the present study, the dynamic viscoelastic behavior (DVB) and flow behavior of fresh tilapia (Oreochromis mossambicus) meat containing cryoprotectants were evaluated with and without water washing. The DVB profile of washed meat with 4% sucrose and sorbitol indicated the maximum structure buildup reaction up to 56.8 °C; thereafter, hydrophobic interactions leading to decreased gelation were suppressed. In both the samples, there was no clear indication of the sol-gel transition temperature. In flow-profile measurements, the presence of cryoprotectants gave rise to the minimum thixotropic area, indicating a low level of impairment in structure. The shear-stress sweep of water-washed tilapia proteins added with cryoprotectants did not reveal significant changes at 28 and 40 °C. In texture-profile analysis, the hardness values were lower in fresh meat than cooked meat. The findings of this study will be helpful in the formulation and design of various mince-based products and in determining the appropriate use of cryoprotectants and water washing in the processing of minced meat.