American society for metabolic and bariatric surgery: intra-operative care pathway for minimally invasive Roux-en-Y gastric bypass.

BACKGROUND: Clinical care pathways help guide and provide structure to clinicians and providers to improve healthcare delivery and quality. The Quality Improvement and Patient Safety Committee (QIPS) of the American Society for Metabolic and Bariatric Surgery (ASMBS) has previously published care pathways for the performance of laparoscopic sleeve gastrectomy (LSG) and pre-operative care of patients undergoing Roux-en-Y gastric bypass (RYGB). OBJECTIVE: This current RYGB care pathway was created to address intraoperative care, defined as care occurring on the day of surgery from the preoperative holding area, through the operating room, and into the postanesthesia care unit (PACU). METHODS: PubMed queries were performed from January 2001 to December 2019 and reviewed according to Level of Evidence regarding specific key questions developed by the committee. RESULTS: Evidence-based recommendations are made for care of patients undergoing RYGB including the pre-operative holding area, intra-operative management and performance of RYGB, and concurrent procedures. CONCLUSIONS: This document may provide guidance based on recent evidence to bariatric surgeons and providers for the intra-operative care for minimally invasive RYGB.

Cortical beta oscillations help synchronise muscles during static posture holding in healthy motor control.

How cortical oscillations are involved in the coordination of functionally coupled muscles and how this is modulated by different movement contexts (static vs dynamic) remains unclear. Here, this is investigated by recording high-density electroencephalography (EEG) and electromyography (EMG) from different forearm muscles while healthy participants (n = 20) performed movement tasks (static and dynamic posture holding, and reaching) with their dominant hand. When dynamic perturbation was applied, beta band (15-35 Hz) activities in the motor cortex contralateral to the performing hand reduced during the holding phase, comparative to when there was no perturbation. During static posture holding, transient periods of increased cortical beta oscillations (beta bursts) were associated with greater corticomuscular coherence and increased phase synchrony between muscles (intermuscular coherence) in the beta frequency band compared to the no-burst period. This effect was not present when resisting dynamic perturbation. The results suggest that cortical beta bursts assist synchronisation of different muscles during static posture holding in healthy motor control, contributing to the maintenance and stabilisation of functional muscle groups. Theoretically, increased cortical beta oscillations could lead to exaggerated synchronisation in different muscles making the initialisation of movements more difficult, as observed in Parkinson's disease.

Influence of drying time on the removal of blood from medical devices.

BACKGROUND: When processing surgical instruments after use, the safe, residue-free removal of blood and blood-containing soiling is one of the most important tasks. There are recommendations from various working groups regarding the ideal time frame for cleaning used instruments in order to ensure safe disinfection and sterilisation and avoid adverse effects. These are generally based primarily on practical experience and there is little systematic work on this topic. AIM: In the present study, cleaning experiments with test specimens previously contaminated with sheep's blood were carried out and in this way the effects of the drying time of whole blood on the results of the subsequent cleaning were examined. METHODS: Reflecting practice, both visual and spectroscopic methods were used to quantify residual protein. The experimental results were evaluated both as a function of the drying time and the residual moisture of the blood. FINDINGS: It was found that drying blood is particularly difficult to remove within the first 1-2 hours. In this phase, in which the blood is coagulated but not yet completely dried, considerably more protein residues remained on the test specimens after cleaning than after longer standing times. CONCLUSIONS: It was concluded that there is a time frame for the removal of blood residues in which optimum cleaning results can be expected. As a consequence, there are also standing times that are disadvantageous for reprocessing. Based on the experimental data, it was deduced that this optimum time is either directly after contamination or in the range of > 3 h and < 24 h after soiling.

The role of cognition as a factor regulating the diving responses of animals, including humans.

The dive response involves three main components - breath holding, reduced heart rate and increased peripheral vasoconstriction - and is ubiquitous during forced dives in air-breathing vertebrates; however, numerous studies in free-diving animals have shown that the heart rate response to diving varies considerably in a manner that suggests cognitive control. Furthermore, studies on free-diving animals and controlled experiments in trained animals both indicate that the dive response can be conditioned, such that the reduction in heart rate begins before submergence and the extent of the reduction is set early in the dive. In addition, numerous species also experience an increase in heart rate and blood flow during ascent at the end of a dive, a phenomenon commonly called 'ascent tachycardia'. Collectively, these data suggest that although the dive response is under autonomic control, many species can vary its magnitude depending on the length and type of the planned dive - an indication of a role for cognition in the overall physiological responses associated with diving. Here, we provide examples of the conditioned cardiac responses - including anticipatory changes in heart rate - in several diving species and propose potential underlying mechanisms. We also discuss how the anticipatory cardiovascular responses not only improve diving capacity, but also prevent diving-related problems, such as decompression sickness or barotrauma, through a mechanism described by the selective gas exchange hypothesis.

A green extraction method for agar with improved thermal stability and water holding capacity.

The conventional agar extraction method has drawbacks such as high energy consumption, low yield, poor quality, and possible residual harmful factors, which greatly limit its application in high-end fields such as biomedicine and high-end materials. This work explored a new freezing-thawing-high-temperature coupling technique for agar extraction. It increased the yield and the strength of agar by 10.6 % and 13.7 %, respectively, as compared to direct high-temperature extraction of agar (HA). The greater molecular weight and lower sulfate content of agar obtained from freeze-thaw cycles combined with high temperature extraction (FA) may be attributed to the desulfurization effect caused by freeze-thaw cycles and the preservation of the molecular chain structure. The reduction in sulfate content decreases the steric hindrance resistance of the polysaccharide chains, enhances their interactions, and promotes the regularity and density of the agar structure, while also improving its water retention and thermal stability. In conclusion, this research can offer a theoretical basis and guidance for the eco-friendly extraction of agar with improved agar characteristics and expended its applications.

Find alternative for bovine and porcine gelatin: Study on physicochemical, rheological properties and water-holding capacity of chicken lungs gelatin by ultrasound treatment.

In this study, the study on physicochemical, rheological properties and water-holding capacity of gelatin of chicken lungs was investigated to replace bovine and porcine gelatin. The extraction rates of chicken, bovine and porcine lung gelatin by ultrasound assisted alkaline protease were 52.12 %, 69.06 % and 70 %, respectively. Three lung gelatins had similar molecular weight distribution in SDS-PAGE with low content of high molecular weight subunits. The amino acid content of bovine lung gelatin (18.03 %) was higher than in chicken (16.62 %) and porcine lung (15.30 %). The highest intensity of 2θ = 7.5° diffraction peak in bovine lung gelatin was observed, which indicated that the triple helix content of bovine lung gelatin was higher than that of chicken and porcine lung gelatin. The lowest apparent viscosity of chicken lung gelatin was 0.253 mPa·s, but the highest water holding capacity of chicken lung gelatin was 331.72 %. Therefore, chicken lung gelatin can be used as a substitute for bovine and porcine gelatin in some functional properties.

Enhancing Solanum lycopersicum Resilience: Bacterial Cellulose Alleviates Low Irrigation Stress and Boosts Nutrient Uptake.

The use of natural-origin biomaterials in bioengineering has led to innovative approaches in agroforestry. Bacterial cellulose (BC), sharing the same chemical formula as plant-origin cellulose (PC), exhibits significantly different biochemical properties, including a high degree of crystallinity and superior water retention capacity. Previous research showed that natural-origin glucose-based chitin enhanced plant growth in both herbaceous and non-herbaceous plants. In this study, we produced BC in the laboratory and investigated its effects on the substrate and on Solanum lycopersicum seedlings. Soil amended with BC increased root growth compared with untreated seedlings. Additionally, under limited irrigation conditions, BC increased global developmental parameters including fresh and dry weight, as well as total carbon and nitrogen content. Under non-irrigation conditions, BC contributed substantially to plant survival. RNA sequencing (Illumina®) on BC-treated seedlings revealed that BC, despite its bacterial origin, did not stress the plants, confirming its innocuous nature, and it lightly induced genes related to root development and cell division as well as inhibition of stress responses and defense. The presence of BC in the organic substrate increased soil availability of phosphorus (P), iron (Fe), and potassium (K), correlating with enhanced nutrient uptake in plants. Our results demonstrate the potential of BC for improving soil nutrient availability and plant tolerance to low irrigation, making it valuable for agricultural and forestry purposes in the context of global warming.

Effect of surgical mask and N95 respirator mask use on cerebrovascular reactivity.

Background and purpose:

Face masks are crucial parts of personal protective equipment (PPE) to reduce the risk of respiratory infections. The COVID-19 outbreak has increased healthcare workers’ use of face masks. This study aimed to evaluate changes in cerebrovascular response among healthcare workers using surgical and N95 respirator masks. 

90 healthcare workers: 30 wearing surgical masks, 30 wearing N95 respirators, and 30 without masks were included. After two-hour of face mask use, the baseline mean flow velocity (MFV) and the mean breath-holding index (BHI) of the bilateral middle cerebral arteries (MCAs) were evaluated with transcranial Doppler ultrasound. The presence of de-novo headache was recorded. BHI values ​​below 0.69 were evaluated as a sign of impaired cerebrovascular reactivity (CVR). 

The rate of de-novo headache was significantly higher in the N95 respirator mask group (p = 0.004). Compared to the control and surgical mask groups, the N95 respirator mask group had significantly lower values of the baseline MFV of the right MCA (p = 0.003 and p = 0.021, respectively) and mean BHI (p = 0.003 and p = 0.012, respectively). Still, only one N95 respirator mask user had a mean BHI value below 0.69.

Surgical masks did not signi­fi­cantly affect cerebral hemodynamics. Although N95 respirator mask use significantly decreased BHI values, the CVR is still within normal limits, and the development of de-novo headache is not directly associated with low CVR. 

Effect of Si and Holding Time on Ti2Al20La Phase in Al-Ti-La Intermediate Alloy.

The effects of holding time and Si on the content, shape size and structure of Ti2Al20La phase in Al-Ti-La intermediate alloy were investigated by an X-ray diffractometer, scanning electron microscope and transmission electron microscope. The results show that the volume fraction and aspect ratio of Ti2Al20La phase in Al-Ti-La intermediate alloy decrease significantly, from 21% and 2.3 without Si addition to 4% and 2.0 with the addition of 2.3 wt.% Si at a holding time of 15 min at 750 °C, respectively. The Si element will attach to the Ti2Al20La phase and form La-Si binary phase at the grain boundary of α-Al. With the increase of holding time from 15 min to 60 min, the content of Ti2Al20La phase in the alloy gradually decreases and the size decreases significantly. Meanwhile, Al11La3 will dissolve and disappear, while the content of La-Si binary phase increases, and part of Ti2Al20La phase transforms into Ti2(Al20-x,Six)La phase.

Effect of bittern immersion on textural properties and water-holding capacity in beef.

Hard meat has low market value; hence, we used bittern as a novel meat tenderizer for bovine M. semitendinosus, one of a hard muscle. We investigated the effects of beef immersion in bittern, a basic solution primarily comprising MgCl2, on textural properties and water-holding capacity. Muscle samples from M. semitendinosus of Holstein steers were immersed in seven different solutions (RO, NaCl, MgCl2, red wine, pH 3, bittern, and pH 8) and heated at 80°C for 5min. The pH of the beef and immersion solutions, water-holding capacity, and maximum load of the meat were measured. Although beef immersed in red wine (pH 3) had a lower pH and water-holding capacity, that immersed in bittern (pH 8.4) had a higher pH and higher water holding capacity. These results indicate that immersion in acidic red wine may harden beef and that immersion in basic bittern may be more effective in maintaining water-holding capacity and softening beef.

Electrical stimulation and wet ageing effects on the carcass and meat quality of Australian rangeland goats.

Medium voltage electrical stimulation and wet ageing periods effects on the carcasses and meat quality of Australian rangeland goats were investigated. 64 rangeland goats were slaughtered as 2 equal consignments, wherein half were exposed to post-dressing electrical stimulation (300 V, 500 ms pulse width, 45 s) and half were not (control). Carcass and pH decline parameters and glycogen concentration were recorded. At 24 h post-mortem, fresh colour was measured and longissimus lumborum muscles (LL) removed. Within carcass, paired LL were halved and allocated to each of 4 ageing periods (1, 2, 4, or 21 d). There were no significant effects from electric stimulation on LL pH at 18 °C, LL temperature at pH 6, LL pH at 24 h post-mortem, semitendinosus pH at 24 h post-mortem, and LL glycogen concentration. There were no significant interactions between stimulation and ageing period on cooking loss, particle size, purge loss, sarcomere length, shear force, and ultimate pH. Independent to stimulation, shear force, particle size, and cooking values declined as ageing period increased. Purge loss was highest after 21 d of ageing. Colour stability was unaffected by ageing, although all CIE colour coordinates varied across the 74 h total retail display period. There were negative linear relationships found between LL glycogen concentrations and LL temperature at pH 6, ultimate pH, and sarcomere length. These findings suggest there to be little benefit to post-dressing electrical stimulation of rangeland goat carcasses, when applied independent to or in combination with ageing.

Evaluation of low-temperature ultrasonic marination of pork meat at various frequencies on physicochemical properties, myoglobin levels, and volatile compounds.

This study aims to evaluate the pork meat quality after ultrasonic brining at different frequencies, thereby providing a more comprehensive understanding of the effects of ultrasound marination on meat. The texture profile analysis showed that ultrasonic curing at various frequencies significantly improved the textural properties of samples, especially at 26.8 kHz, resulting in a reduction of tenderness, hardness, and chewiness values by 44%, 43%, and 44%, respectively. The cooking loss of samples marinated by ultrasound decreased from 27% without ultrasonic treatment to 22%, indicating a significant improvement in water-holding capacity, while the changes in pH had only a subtle impact on pork quality. Meanwhile, the color of pork became more rosy hue due to decreased L⁎ values and increased a⁎ values, which was mainly attributed to an elevated proportion of oxymyoglobin and reduced metmyoglobin content. Additionally, ultrasonic marination did not exert a negative impact on the oxidation of pork protein and lipids. After roasting, samples marinated by ultrasound exhibited a significantly higher abundance of volatile flavor compounds compared to static marinated meat (with an increase of 16 flavor substances) and fresh pork (with an increase of 24 flavor substances), demonstrating the efficacy of ultrasonic marination in enhancing the overall flavor and taste profile of pork. Consequently, the application of ultrasonic technology holds great potential for the "home kitchen type" rapid marination.

Alterations in the fillet quality of myostatin-knockout red sea bream Pagrus major: Preliminary insights into nutritional, compositional, and textural properties.

Myostatin (MSTN) is a negative regulator of skeletal muscle growth and a popular target for enhancing the productivity of farmed fish. We previously developed an mstn-knockout breed of the aquaculture fish red sea bream (Pagrus major) using genome editing technology. However, little is known about the effects of mstn disruption on the fillet quality of red sea bream and other fish species. In this study, we used fillets of mstn-deficient red sea bream to evaluate their compositional and textural changes during refrigeration. Compared to the wild type, the mutant fillets exhibited an increase in moisture content and a decrease in drippings, indicating an enhanced water-holding capacity. Furthermore, the mutant fillets showed increased water retention and marginally lower collagen content, resulting in lower breaking force, an index of texture. In conclusion, we demonstrated that mstn disruption alters the compositional and textural properties of red sea bream fillets.

Use of sustainable packaging materials for fresh beef vacuum packaging application and product assessment using physicochemical means.

Packaging material should guarantee the longest possible shelf life of food and help to maintain its quality. The aim of the study was to assess the physicochemical changes taking place during 28-day ageing of beef steaks packed in two types of multilayer films containing biodegradable polymers - polylactic acid (NAT/PLA) and Mater-Bi® (NAT/MBI). The control group consisted of steaks packed in synthetic polyamide/polyethylene (PA/PE) film. The samples stored in NAT/PLA had significantly lower purge loss than the control samples and the lowest expressible water amount after 14 and 21 days. Following blooming, the most favourable colour was shown in steaks stored in NAT/MBI, with the highest values for the L*, a* and C* parameters and the R630/580 ratio, a high proportion of oxymyoglobin, and the lowest share of metmyoglobin. All steaks, regardless of the type of packaging material, had acceptable tenderness and were stable in terms of lipid oxidation.

Evaluation of platelet concentrates prepared using different methods after overnight holding (18-24 h) of whole blood at room temperature.

BACKGROUND AND OBJECTIVES: Regulatory requirement of fixed holding time (6 h) of whole blood (WB) at room temperature, that is, 22-24°C (RT) results in sub-optimal component separation. The aim was to evaluate the platelet concentrates (PC) prepared by both platelet rich plasma (PRP) and buffy coat (BC) methods after overnight hold (18-24 h) at RT. MATERIALS AND METHODS: A prospective experimental study was performed. A total of 48 WB units collected were divided into four groups (12 each) control-1 (C1) and test-1 (T1) for PRP and control-2 (C2) and test-2 (T2) for the BC method. Control groups were processed within 6 h, and in test groups, components were prepared after overnight hold, followed by evaluation of quality parameters. RESULTS: Irrespective of the method used, all PCs had similar volume, platelet yield, swirling, no bacterial contamination, RBC contamination, PaO2 and PaCO2 levels. PCs in the T1 group had significant differences in glucose and MPV values on d1, which were resolved by d5 of storage. PCs in T2 has significant differences in pH, glucose, and MPV levels throughout storage. PRBC in test and control groups had similar quality parameters till d42 of storage. FFPs in all tests were noninferior to the concurrent control groups till 3 months of storage. CONCLUSION: Overnight holding of WB had no lasting deleterious changes. Though a few biochemical parameters in the test groups were significantly different, they can be accepted to improve the logistics of component separation. Overall PRP method seemed to have a better result than the BC method after an overnight hold.

The carcass characteristics and quality of meat from lambs grazing perennial wheat with different companion legumes (clover, serradella, lucerne) or a mineral supplement.

This study compared carcasses as well as the quality and mineral concentration of meat from lambs extensively grazing perennial wheat with clover (PW + C), serradella (PW + S), lucerne (PW + L), or a mineral salt supplement (PW + Min). A split-plot design was used, wherein 3 crossbred ewe lambs (n = 72 in total) (sub-plots) grazed each of 4 forage types (plots), that were replicated across 6 locations (blocks). The feeding study concluded after 96 d, when all the lambs were slaughtered. The left longissimus lumborum muscles (LL) were collected and wet aged for either 5 or 56 d post-mortem. Lambs grazing PW + Min were found to produce carcasses with lower dressing percentage values to those grazing the other forage types (P = 0.037). The LL of lambs grazing PW + L had the lowest crude protein values (P = 0.015). Forage type by ageing period interactions did not affect meat quality. The 56 d ageing period resulted in higher purge loss (P < 0.001) and TVB-N values (P < 0.001) and a decline in shear force (P < 0.001) compared to the 5 d ageing period. The other carcass and meat quality parameters were not affected by forage type; including hot carcass weight, pH decline parameters, eye muscle area, cooking loss, intramuscular fat, sarcomere length, colour stability, and concentrations of calcium, iron, magnesium, sodium, and zinc in the LL. These findings confirm that perennial cereal production systems, that include legume forages with contrasting protein, energy, and micronutrient profiles, can deliver comparable lamb carcasses and meat quality.

[Functional recovery in older inpatients with hypertension and ischemic heart disease post-COVID-19.]

Understanding the recovery process of functional abilities post-COVID-19 in older inpatients with arterial hypertension and ischemic heart disease is important for optimising healthcare delivery and resources. Participants in this study were individuals undergoing hospital-based rehabilitation following COVID-19 (average age 66, n=183). They were categorised into groups with arterial hypertension (n=92), ischemic heart disease (n=18), both conditions (n=38), and a control group without these diseases (n=35). Functional abilities were assessed via the distance walked until signs of exhaustion (meters), handgrip strength (kilograms), and breath-holding time (seconds). Multiple regression analysis revealed that inpatients with arterial hypertension walked shorter distances (ß=-19,183; p=0,050) but showed higher handgrip strength (ß=3,735; p=0,025) compared to the control group. Post-rehabilitation, inpatients with hypertension demonstrated greater performance (ß=40,435, p=0,024) and better improvement rates (ß=47,337; p=0,016) in walked distance than those in the control group. Significant interaction effects between groups and pre-/post-rehabilitation changes were observed only for walking distance (ß=34,74; p=0,02), with no significant interactions found for other measures. The findings indicate that older inpatients with arterial hypertension may experience comparable or enhanced recovery of functional abilities post-COVID-19. The presence of ischemic heart disease, alone or combined with hypertension, does not significantly impair rehabilitation outcomes compared to those without such conditions.

Combined Relaxation Spectra for the Prediction of Meat Quality: A Case Study on Broiler Breast Fillets with the Wooden Breast Condition.

This study evaluated the potential of using combined relaxation (CRelax) spectra within time-domain nuclear magnetic resonance (TD-NMR) measurements to predict meat quality. Broiler fillets affected by different severities of the wooden breast (WB) conditions were used as case-study samples because of the broader ranges of meat-quality variations. Partial least squares regression (PLSR) models were established to predict water-holding capacity (WHC) and meat texture, demonstrating superior CRelax capabilities for predicting meat quality. Additionally, a partial least squares discriminant analysis (PLS-DA) model was developed to predict WB severity based on CRelax spectra. The models exhibited high accuracy in distinguishing normal fillets from those affected by the WB condition and demonstrated competitive performance in classifying WB severity. This research contributes innovative insights into advanced spectroscopic techniques for comprehensive meat-quality evaluation, with implications for enhancing precision in meat applications.

The Effect of Static Apnea Diving Training on the Physiological Parameters of People with a Sports Orientation and Sedentary Participants: A Pilot Study.

Diver training improves physical and mental fitness, which can also benefit other sports. This study investigates the effect of eight weeks of static apnea training on maximum apnea time, and on the physiological parameters of runners, swimmers, and sedentary participants, such as forced vital capacity (FVC), minimum heart rate (HR), and oxygen saturation (SpO2). The study followed 19 participants, including five runners, swimmers, sedentary participants, and four competitive divers for reference values. The minimum value of SpO2, HR, maximum duration of apnea, and FVC were measured. Apnea training occurred four times weekly, consisting of six apneas with 60 s breathing pauses. Apnea duration was gradually increased by 30 s. The measurement started with a 30 s apnea and ended with maximal apnea. There was a change in SpO2 decreased by 6.8%, maximum apnea length increased by 15.8%, HR decreased by 9.1%, and FVC increased by 12.4% for the groups (p < 0.05). There were intra-groups changes, but no significant inter-groups difference was observed. Eight weeks of apnea training improved the maximum duration of apnea, FVC values and reduced the minimum values of SpO2 and HR in all groups. No differences were noted between groups after training. This training may benefit cardiorespiratory parameters in the population.

Natural aromatic extract of black tea improved the water retention of pork meat batter.

The effect of varying proportions (w/w) of natural aromatic extract of black tea (NAEBT) with pre-emulsification on the water-holding capacity (WHC) of pork meat batter was investigated. The addition of NAEBT significantly reduced the cooking loss (CL) of pork meat batter from 23.95 % to 18.30 % (P < 0.05). Furthermore, NAEBT with pre-emulsification significantly improved the color stability and increased the springiness (P < 0.05). The results of TBARS and carbonyls indicated that NAEBT with pre-emulsification significantly alleviated oxidative damage to proteins (P < 0.05), resulting in an increased level of ß-sheet (P < 0.05), as confirmed by FT-IR analysis. As a result, the water mobility of pork meat batter was restricted (P < 0.05), resulting in an increase in the energy storage modulus (P < 0.05) and a decrease in the pore size. In summary, the WHC of pork meat batter was improved by the antioxidant effect of the NAEBT.