Volatile composition and aroma activity of guava puree before and after thermal and dense phase carbon dioxide treatments.

Volatiles from initially frozen, dense phase carbon dioxide (DPCD)- and thermally treated guava purees were isolated by solid phase microextraction (SPME), chromatographically separated and identified using a combination of gas chromatography-mass spectrometry (GC-MS), GC-olfactometry (GC-O), and GC-pulsed flame photometric detector (GC-PFPD, sulfur mode). Fifty-eight volatiles were identified using GC-MS consisting of: 6 aldehydes, 2 acids, 15 alcohols, 6 ketones, 21 esters, and 8 terpenes. Eleven volatiles were newly identified in guava puree. Hexanal was the most abundant volatile in all 3 types of guava puree. Ten sulfur compounds were identified using GC-PFPD of which 3 possessed aroma activity and 3 were not previously reported in guava puree. Both treatments profoundly reduced total sulfur peak areas and produced different peak patterns compared to control. Thermal treatment reduced total sulfur peak area 47.9% compared to a loss of 34.7% with DPCD treatment. Twenty-six volatiles possessed aroma activity. (Z)-3-Hexenyl hexanoate was the major contributor to the aroma of the freshly thawed and DPCD-treated guava puree. DPCD treatment reduced total MS ion chromatogram (MS TIC) peak area 35% but produced a GC-O aroma profile very similar to control. Whereas thermal treatment reduced total TIC peak area only 8.7% compared to control but produced a 35% loss in total GC-O peak intensities.

Obesity and vehicle type as risk factors for injury caused by motor vehicle collision.

BACKGROUND: This study sought to describe variations in the risk of motor vehicle collision (MVC) injury and death by occupant body mass index (BMI) class and vehicle type. We hypothesized that the relationship between BMI and the risk of MVC injury or mortality would be modified by vehicle type. METHODS: This is a retrospective cohort study of occupants involved in MVCs using data from the Crash Injury Research and Engineering Network and the National Automotive Sampling System Crashworthiness Data System. Occupants were grouped based on vehicle body style (passenger car, sport utility vehicle, or light truck) and vehicle size (compact or normal, corresponding to below- or above-average curb weight). The relationship between occupant BMI class (underweight, normal weight, overweight, or obese) and risk of injury or mortality was examined for each vehicle type. Odds ratios (ORs) adjusted for various occupant and collision characteristics were estimated. RESULTS: Of an estimated 44 million occupants of MVCs sampled from 2000 to 2009, 37.1% sustained an injury. We limited our analysis to injuries achieving an Abbreviated Injury Scale (AIS) score of 2 or more severe, totaling 17 million injuries. Occupants differed substantially in terms of demographic and collision characteristics. After adjustment for confounding factors, we found that obesity was a risk factor for mortality caused by MVC (OR, 1.6; 95% confidence interval [CI], 1.2-2.0). When stratified by vehicle type, we found that obesity was a risk factor for mortality in larger vehicles, including any-sized light trucks (OR, 2.1; 95% CI, 1.3-3.5), normal-sized passenger cars (OR, 1.6; 95% CI, 1.1-2.3), and normal-sized sports utility vehicles or vans (OR, 2.0; 95% CI, 1.0-3.8). Being overweight was a risk factor in any-sized light trucks (OR, 1.5; 95% CI, 1.1-2.1). CONCLUSION: We identified a significant interaction between occupant BMI class and vehicle type in terms of MVC-related mortality risk. Both factors should be taken into account when considering occupant safety, and additional study is needed to determine underlying causes of the observed relationships. LEVEL OF EVIDENCE: Epidemiologic study, level III.

Serum ferritin levels lack diagnostic accuracy for liver fibrosis in patients with nonalcoholic fatty liver disease.

BACKGROUND & AIMS: Series studies have associated increased serum levels of ferritin with liver fibrosis in patients with nonalcoholic fatty liver disease. We aimed to determine the accuracy with which measurements of serum ferritin determine the presence and severity of liver fibrosis, and whether combining noninvasive scoring systems with serum ferritin analysis increases the accuracy of diagnosis of advanced liver fibrosis. METHODS: We performed a retrospective analysis of data from 1014 patients with liver biopsy-confirmed nonalcoholic fatty liver disease. Three cut points of serum ferritin level, adjusted for sex, were established based on receiver operating characteristic curve analysis: 1.0-, 1.5-, and 2.0-fold the upper limit of normal. Three multiple logistic regression models were created to determine the association of these cutoff values with liver fibrosis, adjusting for age, sex, race, diabetes, body mass index, and level of alanine aminotransferase. RESULTS: A greater proportion of patients with increased serum levels of ferritin had definitive nonalcoholic steatohepatitis and more-advanced fibrosis than patients without increased levels. In all models, serum level of ferritin was significantly associated with the presence and severity of liver fibrosis. However, for all 3 cutoff values, area under the receiver operating characteristic curve values were low (less than 0.60) for the presence of fibrosis or any stage of liver fibrosis; ferritin level identified patients with fibrosis with 16%-41% sensitivity and 70%-92% specificity. The accuracy with which noninvasive scoring systems identified patients with advanced fibrosis did not change with inclusion of serum ferritin values. CONCLUSIONS: Although serum levels of ferritin correlate with more-severe liver fibrosis, based on adjusted multiple logistic regression analysis, serum ferritin levels alone have a low level of diagnostic accuracy for the presence or severity of liver fibrosis in patients with nonalcoholic fatty liver disease.

Adaptive coded-aperture imaging with subpixel superresolution.

We describe an adaptive coded-aperture imager operating in the midwave IR. This consists of a coded-aperture mask, a set of optics, and a 4k×4k focal plane array (FPA). This system can produce images with a resolution better than the detector pixel limit by combining multiple frames of data recorded with different coding. This superresolution capability has been demonstrated both in the laboratory and with targets placed outside, the highest resolution being one-half of the FPA pixel pitch.

Patients' commitment to their primary physician and why it matters.

PURPOSE: The patient-physician relationship is the cornerstone of health care service delivery. The objectives of this study were to assess the contribution of relationship commitment along with trust to patient-physician relationships and to evaluate the association of commitment and trust with adherence to medical advice and healthy eating behaviors. METHODS: To test the proposed model, we developed a questionnaire that included both existing scales and a scale constructed specifically for the study; the questions addressed trust, commitment, adherence to physicians' medical recommendations, and healthy eating behavior. The questionnaire was given to adult patients in the waiting rooms of 4 large clinics in central Texas. RESULTS: A total of 1,008 patients returned questionnaires; 869 patients' questionnaires were complete and used in the analysis. A 3-stage least squares analysis that tested a system of 4 equations which included relationship commitment yielded a systemwide R(2) of 0.71 that was 0.09 higher than a system of equations excluding relationship commitment. Trust and commitment were positively associated with adherence (P <.001 and P = .02, respectively). We also found positive relationships between adherence and commitment and between trust and commitment (P <.001 for each). Adherence and commitment were both associated with healthy eating behavior as well (P <.001 for each). CONCLUSIONS: Patients' trust in their physician and commitment to the relationship offer a more complete understanding of the patient-physician relationship. In addition, trust and commitment favorably influence patients' health behaviors.

Pruritic linear papules on a 75-year-old woman: a case of localized Darier-White disease.

Darier-White disease (DWD), commonly called Darier disease or keratosis follicularis, is a genodermatosis seen in clinical practice. It exists more commonly in the generalized form but can present as a localized condition. Localized DWD is a rare entity characterized by epidermal changes that are like those seen in the generalized form but that are confined to a small area of skin. This entity is postulated to result from a postzygotic mutation and has the potential to be transmitted to offspring, which may result in the severe generalized form. We report a case of localized DWD diagnosed after biopsy of a recalcitrant linear dermatitis and discuss the salient features of this condition.