Green banana resistant starch: A promising potential as functional ingredient against certain maladies.

This review covers the significance of green banana resistant starch (RS), a substantial polysaccharide. The food industry has taken an interest in green banana flour due to its 30% availability of resistant starch and its approximately 70% starch content on a dry basis, making its use suitable for food formulations where starch serves as the base. A variety of processing techniques, such as heat-moisture, autoclaving, microwaving, high hydrostatic pressure, extrusion, ultrasound, acid hydrolysis, and enzymatic debranching treatments, have made significant advancements in the preparation of resistant starch. These advancements aim to change the structure, techno-functionality, and subsequently the physiological functions of the resistant starch. Green bananas make up the highest RS as compared to other foods and cereals. Many food processing industries and cuisines now have a positive awareness due to the functional characteristics of green bananas, such as their pasting, thermal, gelatinization, foaming, and textural characteristics. It is also found useful for controlling the rates of cancer, obesity, and diabetic disorders. Moreover, the use of GBRS as prebiotics and probiotics might be significantly proved good for gut health. This study aimed at the awareness of the composition, extraction and application of the green banana resistant starch in the future food products.

Impact of gamma irradiation and guava leaf extract on the quality and storage stability of chicken patties.

The current investigation was carried out to evaluate the impact of gamma irradiation and guava leaf extract (GLE) on chicken meat patties. The effects of treatments on chicken meat patties were determined by physicochemical, stability (oxidative and microbial), and antioxidant status during different packaging (aerobic and vacuum) at storage intervals (0, 5, and 10 days). The changes in physicochemical parameters of chicken patties were observed on various treatments, storage intervals, and different packaging. The TBARS and POV were found to increase significantly (p < .05) on 2 kGy and with the passage of storage time. The results of microbial load in samples were found to decrease on gamma irradiation with and without GLE. The antioxidant profile in chicken patties was with respect to control. Slight changes were seen in sensory parameters on different treatments at storage intervals. It is concluded that gamma irradiation eliminated the microbes and different concentrations of GLE improve the stability and antioxidant profile of chicken patties.

Multicomponent intervention for frail and pre-frail older adults with acute cardiovascular conditions: The TARGET-EFT randomized clinical trial.

BACKGROUND: Hospitalization for cardiovascular disease (CVD) may be complicated by hospital-acquired disability (HAD) and subsequently poor health-related quality of life (HRQOL). While frailty has been shown to be a risk factor, it has yet to be studied as a therapeutic target to improve outcomes. OBJECTIVES: This trial sought to determine the effects of an in-hospital multicomponent intervention targeting physical weakness, cognitive impairment, malnutrition, and anemia on patient-centered outcomes compared to usual care. METHODS: A single-center parallel-group randomized clinical trial was conducted in older patients with acute CVD and evidence of frailty or pre-frailty as measured by the Essential Frailty Toolset (EFT). Patients were randomized to usual care or a multicomponent intervention. Outcomes were HRQOL (EQ-5D-5L score) and disability (Older Americans Resources and Services score) at 30 days post-discharge and mood disturbances (Hospital Anxiety and Depression Scale) at discharge. RESULTS: The trial cohort consisted of 142 patients with a mean age of 79.5 years and 55% females. The primary diagnosis was heart failure in 29%, valvular heart disease in 28%, ischemic heart disease in 14%, arrhythmia in 11%, and other CVDs in 18%. The intervention improved HRQOL scores (coefficient 0.08; 95% CI 0.01, 0.15; p = 0.03) and mood scores (coefficient -1.95; 95% CI -3.82, -0.09; p = 0.04) but not disability scores (coefficient 0.18; 95% CI -1.44, 1.81; p = 0.82). There were no intervention-related adverse events. CONCLUSION: In frail older patients hospitalized for acute CVDs, an in-hospital multicomponent intervention targeted to frailty was safe and led to modest yet clinically meaningful improvements in HRQOL and mental well-being. The downstream impact of these effects on event-free survival and functional status remains to be evaluated in future research, as does the generalizability to other healthcare systems. CLINICAL REGISTRATION NUMBER: NCT04291690.

De-frailing intervention for hospitalized cardiovascular patients in the TARGET-EFT randomized clinical trial.

AIMS: Frailty is disproportionately prevalent in cardiovascular disease patients and exacerbated during hospital admissions, heightening the risk for adverse events and functional decline. Using the Essential Frailty Toolset (EFT) to target physical weakness, cognitive impairment, malnourishment, and anaemia, we tested a multicomponent targeted intervention to de-frail older adults with acute cardiovascular conditions during their hospital admission. METHODS AND RESULTS: The TARGET-EFT trial was a single-center randomized clinical trial at the Jewish General Hospital, Montreal, Canada. We compared a multicomponent de-frailing intervention with usual clinical care. Intervention group patients received exercise, cognitive stimulation, protein supplementation, and iron replacement, as required. In this study, the primary outcome was frailty, as assessed by the SPPB score (Short Physical Performance Battery) at discharge, and the secondary outcome was the SARC-F score (Strength, Assistance walking, Rising from chair, Climbing, Falls) assessed 30 days later. The analysis consisted of 135 patients (mean age of 79.3 years; 54% female) who survived and completed the frailty assessments.Compared with control patients, intervention group patients had a 1.52-point superior SPPB score and a 0.74-point superior SARC-F score. Subgroup analysis suggested that patients with low left ventricular ejection fraction may have attenuated benefits, and that patients who underwent invasive cardiac procedures had the greatest benefits from the intervention. CONCLUSION: We achieved our objective of de-frailing older cardiac inpatients on a short-term basis by improving their physical performance and functioning using a pragmatic multicomponent intervention. This could have positive impacts on their clinical outcomes and ability to maintain independent living in the future. ONE SENTENCE SUMMARY: The multicomponent intervention targeted to the deficits of vulnerable older adults hospitalized with acute cardiovascular diseases successfully de-frailed them on a short-term basis, which can have positive implications on their post-discharge health outcomes.

Severe Mental Illness and Cardiovascular Disease: JACC State-of-the-Art Review.

People with severe mental illness, consisting of schizophrenia, bipolar disorder, and major depression, have a high burden of modifiable cardiovascular risk behaviors and conditions and have a cardiovascular mortality rate twice that of the general population. People with acute and chronic cardiovascular disease are at a higher risk of developing mental health symptoms and disease. There is emerging evidence for shared etiological factors between severe mental illness and cardiovascular disease that includes biological, genetic, and behavioral mechanisms. This state-of-the art review will describe the relationship between severe mental illness and cardiovascular disease, explore the factors that lead to poor cardiovascular outcomes in people with severe mental illness, propose strategies to improve the cardiovascular health of people with severe mental illness, and present areas for future research focus.

Sedentary Time in Older Adults With Acute Cardiovascular Disease.

Background: Older adults may be subject to prolonged bedrest during hospitalization for acute cardiovascular disease, which can contribute to poor functional outcomes posthospitalization. Our objective was to describe mobility status in hospitalized older adults with acute cardiovascular disease. Methods: Patients aged ≥ 60 years old in the cardiac intensive care unit and cardiovascular ward at a tertiary care academic centre in Montréal, Québec were prospectively enrolled from April 2019 to March 2020. Activity levels were measured with the ActiGraph GT9X Link 3-axis accelerometer (ActiGraph, Pensacola, FL). Sedentary was defined as lying in bed or in a sitting position. Health-related quality of life (HRQOL) was measured with the Short-Form 36 (SF-36) questionnaire by telephone at 1 month posthospitalization. The primary outcome was percentage of sedentary time during hospitalization. Results: There were 35 patients included in the analysis (75.7 ± 6.9 years old; 45.7% female; 22.9% ischemic heart disease; 20.0% heart failure). Patients spent 91.2% ± 5.5 in a sedentary position during their hospital stay. Mean steps per minute were 1.0 ± 1.2, and mean kcals consumed per day were 116.6 ± 124.5. In the multivariable analysis, a higher percentage of sedentary time and lower steps per minute were each associated with lower total SF-36 scores at 1-month posthospitalization (both P < 0.05). Conclusions: Older adults with acute cardiovascular disease may be sedentary for a large part of their hospital stay. Increased sedentary time is associated with worse self-reported posthospital HRQOL. Future studies are needed to determine whether interventions to increase activity during hospitalization improve posthospital HRQOL and functional outcomes.

Introduction: Les personnes âgées hospitalisées en raison d'une maladie cardiovasculaire en phase aiguë peuvent être sujettes à un alitement prolongé qui peut contribuer à des résultats fonctionnels médiocres après l'hospitalisation. Notre objectif était de décrire l'état de mobilité des personnes âgées hospitalisées en raison d'une maladie cardiovasculaire en phase aiguë. Méthodes: Nous avons inscrit de façon prospective les patients de ≥ 60 ans de l'unité des soins intensifs cardiaques et de l'unité de cardiologie d'un centre universitaire de soins tertiaires à Montréal, au Québec, d'avril 2019 à mars 2020. Nous avons mesuré les niveaux d'activité physique à l'aide de l'accéléromètre ActiGraph GT9X Link 3-axis (ActiGraph, Pensacola, Floride, É.-U.). Nous avons défini la sédentarité par le fait d'être couché au lit ou en position assise. Nous avons mesuré la qualité de vie liée à la santé (QVLS) à l'aide du questionnaire SF-36 (Short Form-36) par téléphone un mois après l'hospitalisation. Le critère de jugement principal était le pourcentage de temps sédentaire durant l'hospitalisation. Résultats: Dans l'analyse, on comptait 35 patients (75,7 ± 6,9 ans; 45,7 % de femmes; 22,9 % atteints d'une cardiopathie ischémique; 20,0 % atteints d'insuffisance cardiaque). Les patients passaient 91,2 % ± 5,5 en position sédentaire durant leur séjour à l'hôpital. Les pas moyens par minute étaient de 1,0 ± 1,2, et les kcal moyennes consommées par jour étaient de 116,6 ± 124,5. Dans l'analyse multivariée, un pourcentage plus élevé de temps sédentaire et un nombre inférieur de pas par minute étaient chacun associés à des scores totaux plus faibles au SF-36 un mois après l'hospitalisation (P < 0,05, pour les deux). Conclusions: Les personnes âgées atteintes d'une maladie cardiovasculaire en phase aiguë se retrouvent sédentaires pendant une grande partie de leur séjour à l'hôpital. L'augmentation du temps sédentaire est associée à une plus mauvaise QVLS après l'hospitalisation selon les personnes âgées interrogées. Des études ultérieures sont nécessaires pour déterminer si les interventions pour accroître l'activité physique durant l'hospitalisation améliorent la QVLS et les résultats fonctionnels après l'hospitalisation.

Mechanistic role of astaxanthin derived from shrimp against certain metabolic disorders.

Oxidative stress caused by the imbalance between production of oxidants and antioxidants in the body leads to the development of different ailments. The bioactive compounds derived from marine sources are considered to be safe and appropriate to use. Astaxanthin possesses antioxidant activity about 100-500 times higher than other antioxidants such as α-tocopherol and ß-carotene. It has numerous health benefits and vital pharmacological properties for the treatment of diseases like diabetes, hypertension, cancer, heart disease, ischemia, neurological disorders, and potential role in liver enzyme gamma-glutamyl transpeptidase which has significance in medicine as a diagnostic marker. The primary source of astaxanthin among crustaceans is shrimps and the presence of astaxanthin protects shrimps from oxidation of polyunsaturated fatty acids and cholesterol. Conclusively, astaxanthin derived from shrimps is very effective against oxidative stress which can lead to certain ailments.

Health-Related Quality of Life in Older Adults With Acute Cardiovascular Disease Undergoing Early Mobilization.

BACKGROUND: Early mobilization (EM) is safe and feasible in older adults with acute cardiovascular disease (CVD) and may improve posthospitalization patient-centred outcomes. Our objective was to assess posthospitalization health-related quality of life (HRQOL) in older adults with acute CVD undergoing EM. METHODS: Patients aged ≥ 60 years with acute CVD undergoing EM at an academic tertiary centre in Montreal, Quebec were prospectively enrolled from January 2018 to January 2020. Functional status was measured using the validated Level of Function Mobility Scale. HRQOL was measured using the Short-Form 36 questionnaire at 1 and 12 months posthospitalization. The primary outcome was the questionnaire's physical component summary (PCS) score at 1 month posthospitalization. RESULTS: There were 147 patients included in the analysis (aged 75.0 ± 8.7 years; 44.6% female; 48.6% with ischemic heart disease). The mean 1-month PCS score was 34.7 ± 9.7, which was 11.5 points and 8.4 points lower compared to age-matched Canadian normative data for people ages 65-74 years and ≥ 75 years, respectively. The mean PCS score at 12 months (36.5 ± 9.2) and the mean mental component summary scores at 1 and 12 months (36.9 ± 11.1; 40.5 ± 11.5) were lower than those of the age-matched population (all P < 0.0001). In the multivariable analysis, increased age and worse prehospitalization function were associated with lower PCS score at 1 month. CONCLUSIONS: Older adults with acute CVD had lower HRQOL at 1 and 12 months posthospitalization than age-matched Canadian norms. Prehospitalization functional status was predictive of poor posthospitalization HRQOL. The EM program was safe and feasible in this patient population. Further studies are needed to determine whether EM can improve posthospitalization patient-centred outcomes in older adults, particularly those with poor prehospitalization functional status.

INTRODUCTION: La mobilisation précoce (MP) est sécuritaire et réalisable chez les personnes âgées atteintes d'une maladie cardiovasculaire (MCV) aiguë et peut permettre d'améliorer les résultats axés sur les patients après l'hospitalisation. Notre objectif était d'évaluer la qualité de vie liée à la santé (QVLS) après l'hospitalisation chez les personnes âgées atteintes d'une MCV aiguë se soumettant à la MP. MÉTHODES: Les patients ≥ 60 ans atteints d'une MCV aiguë se soumettant à la MP dans un centre universitaire de soins tertiaires à Montréal, au Québec, ont été inscrits de façon prospective de janvier 2018 à janvier 2020. Nous avons mesuré l'état fonctionnel au moyen de l'échelle de mobilité fonctionnelle validée. Nous avons mesuré la QVLS à l'aide du questionnaire d'évaluation de la santé en version abrégée (SF-36, de l'anglais Short-Form 36 questionnaire) un mois et 12 mois après l'hospitalisation. Le principal critère d'évaluation était les scores du sommaire de la composante physique (SCP) du questionnaire un mois après l'hospitalisation. RÉSULTATS: Cent quarante-sept patients ont fait l'objet de l'analyse (âgés de 75,0 ± 8,7 ans; 44,6 % de femmes; 48,6 % atteints d'une cardiopathie ischémique). Les scores moyens du SCP après un mois étaient de 34,7 ± 9,7, soit 11,5 points et 8,4 points plus bas que les données normatives canadiennes appariées selon l'âge pour les personnes de 65 à 74 ans et ≥ 75 ans, et ce, respectivement. Les scores moyens du SCP après 12 mois (36,5 ± 9,2) et les scores moyens du sommaire de la composante mentale après un mois et après 12 mois (36,9 ± 11,1; 40,5 ± 11,5) étaient plus bas que les scores de la population appariée selon l'âge (toutes les P < 0,0001). Dans l'analyse multivariée, l'âge avancé et le plus mauvais fonctionnement avant l'hospitalisation ont été associés à un score plus bas du SCP après un mois. CONCLUSIONS: Les personnes âgées atteintes d'une MCV aiguë avaient un mois et 12 mois après l'hospitalisation une QVLS inférieure aux normes canadiennes appariées selon l'âge. L'état fonctionnel avant l'hospitalisation permettait de prédire une QVLS médiocre après l'hospitalisation. Le programme de MP était sécuritaire et réalisable pour ces patients. D'autres études sont nécessaires pour déterminer si la MP peut contribuer à l'amélioration des résultats axés sur les patients après l'hospitalisation chez les personnes âgées, particulièrement chez celles qui ont un état fonctionnel médiocre avant l'hospitalisation.

Prognostic Value of Handgrip Strength in Older Adults Undergoing Cardiac Surgery.

BACKGROUND: Although multidimensional frailty scales have been proven to predict mortality and morbidity in cardiac surgery, there is a need for rapid tools that could be easily administered at the point of care. Handgrip strength (HGS) is an attractive option that can be measured in acutely ill and bed-bound patients, although it has yet to be validated in a large cardiac surgery cohort. METHODS: This is a post hoc analysis of a multicentre prospective study in older patients undergoing coronary artery bypass grafting and/or valve surgery from 2011 to 2019. HGS was measured before surgery and classified by sex-stratified cutoffs. The primary outcome was 1-year mortality and secondary outcomes were 30-day mortality, discharge disposition, and prolonged length of stay. RESULTS: There were 1245 patients included in the analysis (mean age 74.0 ± 6.6 years; 30% female). Weak HGS was associated with advanced age, heart failure, kidney disease, malnutrition, and various frailty scales. In those with weak vs normal HGS, respectively, 1-year mortality was 17% vs 6%, 30-day mortality was 10% vs 3%, prolonged length of stay was 34% vs 19%, and discharge to a health care facility was 45% vs 26% (all P < 0.001). After adjustment, HGS was predictive of 1-year and 30-day mortalities, with odds ratios of 2.44 (95% confidence interval [CI] 1.39-4.29) and 2.83 (1.38-5.81), respectively. HGS cutoffs of < 26 kg in men and < 16 kg in women had the highest predictive performance. CONCLUSIONS: HGS is a simple and effective tool to identify patients at higher risk of mortality and protracted recovery after cardiac surgery.

Exploring the amino acid profile and microbial properties of locally sweet preserved kachra hareer (Terminalia chebula).

The current research was designed to determine the amino acid profile and microbial properties of kachra hareer. For the purpose, kachra hareer was purchased with their brand names coded as S1, S2, S3, and S4 from five towns named as L1, L2, L3, L4, and L5. The samples were analyzed for their amino acid profile and microbial properties, while the water and alcohol extractive values were analyzed to obtain the different levels of purity during processing. The results explained that physicochemical analyses, that is, pH, moisture, acidity, and vitamin C, ranged from 4.67% to 9.44%, 22% to 40%, 0.054% to 1.44%, and 7.67% to 19.36%, respectively. However, essential amino acids histidine, isoleucine, leucine, methionine, phenylalanine, proline, threonine, and valine ranged from 470.3 to 484.5, 516.1 to 527.5, 805.5 to 817.4, 910.1 to 922.5, 240.2 to 250.5, 508.2 to 518.2, 1,160.5 to 1,172.6, 466.9 to 476.3, and 502.5 to 513.4 mg/kg, respectively, whereas nonessential amino acids alanine, arginine, aspartic acid cysteine, glutamic acid, serine, tyrosine, and glycine ranged from 612.7 to 628.2, 1,212.3 to 1,225.9, 7,254.2 to 7,258.8, ND, 1,561.2 to 1,575.2, 634.8 to 648.9, 618.4 to 630.4, and 712.8 to 723.7 mg/kg, respectively. Conclusively, sample S2 showed the maximum nutritional content and minimum microbial load.

Effect of adding Aloe vera jell on the quality and sensory properties of yogurt.

This study was planned to investigate the effect of replacing milk fat with aloe vera gel addition on yogurt quality. Purposely, yogurt was prepared with different concentration of aloe vera gel and coded as AGY0, = Control (3.5% fat and no AG), AGY1 = (1% fat and 1% AG), AGY2 = (1% fat and 2% AG), AGY3 = (1% fat and 3% AG), AGY4 = (2% fat and 1% AG), AGY5 = (2% fat and 2% AG), and AGY6 = (2% fat and 3% AG). Aloe vera gel yogurt was analyzed for physicochemical, microbial, and sensory characteristics with defined interval (0, 7th, 14th, and 21st) days. All attributes of the yogurt were significantly (0.05) affected by the addition of aloe vera gel. Results showed that the pH (4.6-4.05), viscosity (46.4-4.3), WHC (32.8%-26.1%), fat (0.9%-3.48%), protein (3.14%-3.36%), lactose (4.07%-4.23%), ash (0.48%-0.63%), total solids (11.08%-17.18%), SNF (7.69-l5.21%), and TPC (2.36 × 107 to 1.02 × 107 CFU/ml) values of yogurt samples decreased with storage time. However, acidity and syneresis of yogurt increased with the passage of time ranging from 1.12%-1.67% and 0.9-5 ml, respectively. In conclusion, aloe vera improved the texture of the yogurt which leads to higher consumer acceptability. Addition of 3% aloe vera to 1% fat (AGY3) containing buffalo milk yogurt was found to best for physicochemical as well as organoleptic characteristics as well as organoleptic characteristics.

Early mobilization post-myocardial infarction: A scoping review.

Bedrest and immobilization following a myocardial infarction (MI) can lead to functional impairment that can persist following hospitalization. Early mobilization (EM) is associated with good functional and clinical outcomes in critical care, medical and surgical settings. However, the impact and current role of EM in post-MI care has not been well-defined. Our objective was to assess the evidence for post-MI mobilization, define current post-MI mobilization practice, and understand perspectives of cardiovascular professionals toward mobilization. A scoping review related to "early mobilization" and "myocardial infarction" was performed using the Joanna Briggs Institute Methodology. Pubmed, Embase, Google Scholar, Cochrane Library and CINAHL databases were included. Results were categorized into six topic areas. There were 59 references included in the analysis. There was evidence for the effectiveness and safety of earlier mobilization in experimental studies of the pre-revascularization era, but there was a lack of strong evidence for EM in contemporary post-MI care. Mobilization appears to be safe following arterial catheterization and is associated with minimal hemodynamic and respiratory compromise. Most people are delayed in mobilizing post-MI and spend the majority of the initial hospitalization period lying in bed. Only 1 of 7 current major cardiovascular professional societies guidelines recommend EM post-MI. There were no studies exploring the perspectives of cardiovascular professionals toward mobilization. EM may be beneficial in the post-MI care. However, there is an evidence gap for the impact of EM post-MI in the contemporary literature. More robust evidence from randomized clinical trials is required to inform clinicians and influence practice.

Consequences of hydrogenated vegetable fat substitution with Ajwa seed oil on physicochemical and nutritional aspects of functional cookies.

The core objectives of the current study were to explore and compare the proximate and nutritive composition of both types of cookies prepared either with Ajwa seed oil (ASO) or hydrogenated vegetable fat (HVF) and comparative analysis of the antioxidantal potential of both cookies and to reconnoiter the storage effects on the quality parameters of the cookies over a period of 60 days. Outcomes revealed that the cookies prepared with the ASO were superior (p < .05) in fat% and energy as compared to the cookies with HVF. Due to the presence of functional moieties, ASO cookies were found with better palatability, increased shelf life with enhanced physical properties and better functionality. Therefore, the findings of the current study revealed that ASO could be used as an alternative fat source for the preparation of novel functional cookies instead of conventional vegetable fats.