Scoping Review on Transitions in the Context of Pediatric Palliative Care.

Background: Children with complex and chronic conditions receiving palliative care will likely experience many transitions during their life and their treatments. Transition periods for children with life-limiting conditions and their families can be bewildering and highly anxiety-inducing. However, clinical observations seem to point to a more heterogenous care offer, including a lack or discontinuity of services, at the expense of their quality of life. Objective: This paper aims to establish a portrait of the existing literature and identify research gaps on the multiple transitions experienced by this population. Design: A scoping review is provided, following a PRISMA protocol. MEDLINE, PubMed and CINAHL were consulted. The search strategy is based on three key concepts: (1) palliative care/complex condition, (2) child/adolescent, and (3) transition. Articles were screened with the help of Covidence. Results: A total of 72 articles are included for analysis. The aimed population is either identified by age group or by medical status. Respondents are most often parents rather than the children themselves. Transitions include: reaching adulthood, changes in care environment, changes in medical status, and school integration. Conclusion: The discussion notices a definitional murkiness about transitions and highlights the fact that the multifaceted and complex nature of transition over time is largely ignored. New research should involve a diversity of participants and include children's voices. Recommendations include clearer concept definitions, health care policies that adopt an ecosystemic approach, and professional training in the systemic family approach in palliative care.

Nano-encapsulation of coenzyme Q10 using octenyl succinic anhydride modified starch.

Octenyl succinic anhydride modified starch (OSA-ST) was used to encapsulate coenzyme Q10 (CoQ10). CoQ10 was dissolved in rice bran oil and incorporated into an aqueous OSA-ST solution. High pressure homogenisation of the mixture was conducted at 170 MPa for 56 cycles. The resulting emulsion had a particle size range of 200-300 nm and the absolute zeta potential varied between 8.4 and 10.6 mV. CoQ10 retention of the emulsion and freeze dried products, determined by a hexane rinse, was 98.2%. Reconstitution of the freeze dried product in Mcllvaine citrate-phosphate buffers with pH values of 3-5 and temperatures at 4 and 25 °C had very little effect on the range and distribution of the nanoparticles' size. The inflection point of the zeta potential and pH plot occurred at the first pKa of succinic acid (pH 4.2), indicating succinate as the main influence over zeta potential.

Relating raw rice colour and composition to cooked rice colour.

BACKGROUND: The whiter the rice, the more it is preferred by consumers and the more value it has in the market place. The first objective of this study was to determine the interrelationships of raw colour, cooked colour, amylose content and protein content in rice. The second objective was to assess whether or not the colour of cooked rice can be predicted from raw rice colour in conjunction with amylose and protein contents. RESULTS: Protein and amylose contents were not significantly correlated with the colour measurements for raw rice. Protein and amylose showed moderate, significant associations with L* and a* and a*, b* and C* respectively for cooked rice. Only the colour variable a* of cooked rice could be predicted using protein, amylose and raw rice colour with high enough precision to be useful, and this was only for modelling using samples cooked in the same manner (rice cooker). Cooking method (rice cooker versus excess water) affected the colour of cooked rice. CONCLUSION: Being able to predict a* in cooked rice is likely of limited value. Only the model that used samples where postharvest handling conditions were controlled (US-grown rice) was able to predict C*, a more useful measure, and then with only moderate ability. L*, a measure of brightness/whiteness, was not predicted well by any of the models.

Nutritionally important starch fractions of rice cultivars grown in southern United States.

Dietary starches can be classified into 3 major fractions according to in vitro digestibility as rapidly digestible (RDS), slowly digestible (SDS), and resistant starch (RS). Literature indicates that SDS and/or RS have significant implications on human health, particularly glucose metabolism, diabetes management, colon cancer prevention, mental performance, and satiety. In this study, the nutritionally important starch fractions (RDS, SDS, and RS) in cooked rice were assayed in vitro, making use of 16 cultivars grown in 5 southern U.S. rice growing locations (Arkansas, Louisiana, Mississippi, Missouri, and Texas). RDS, SDS, and RS were 52.4% to 69.4%, 10.3% to 26.6%, and 1.2% to 9.0%, respectively, of cooked rice dry weight. Cultivar, location, and cultivar-by-location interaction contributed to the variations in RDS, SDS, and RS contents. Means pooled across locations indicated that SDS was higher for the Louisiana samples than those from Texas, whereas RS was higher for the Texas samples than those from Arkansas, Louisiana, and Mississippi. Some cultivars were identified to possess high levels of RS (for example, Bowman and Rondo) or SDS (for example, Dixiebelle and Tesanai-2) and were also stable across growing locations. Apparent amylose content correlated positively with RS (n = 80, r = 0.54, P 0.05). RS and SDS were not collinear (n = 80, r =or-0.18, P > 0.05); it does not follow that a cultivar high in RS will also be high in SDS, and vice versa. The observed differences in RDS, SDS, and RS among the samples are indicative of wide genetic diversity in rice.

Effects of beer-battering on the frying properties of rice and wheat batters and their coated foods.

BACKGROUND: Beer in batter formulation or beer-battering has been popular in fried food recipes, but the topic is rarely reported in scientific journals or the claims substantiated with reliable studies. In this research, we prepared and characterized rice and wheat batters with and without using beer to replace water in the formulation. We studied and provided data on the effect of beer on the frying properties of batter and its coated foods. RESULTS: With beer in the formulation, oil uptake of fried batters generally increased by up to 18%. Instrumental textural analyses indicate that beer-battering treatment generally decreased the hardness, increased the fracturability and improved the crispness of the fried batters. Sensory evaluations show similar trends, though to a lesser extent, that fish and onion rings coated with batters were softer but crispier with beer than without. CONCLUSION: In general, beer-battering caused an increase in the oil uptake of the batter during frying. It also made the texture of fried batters slightly softer and crispier. The effects are more pronounced for rice batters than wheat batters.

Effects of phytic acid on peanut allergens and allergenic properties of extracts.

Phytic acid would form soluble and insoluble complexes with proteins. Our objective was to determine if phytic acid forms insoluble complexes with major peanut allergens, and if such reaction results in a peanut extract with a lower level of soluble allergens and allergenic property. Extracts from raw and roasted peanuts were treated with and without phytic acid at various pH values and then analyzed by SDS-PAGE and a competitive inhibition ELISA (ciELISA). The ciELISA measured IgE binding using a pooled serum from peanut-allergic individuals. Results showed that phytic acid formed complexes with the major peanut allergens (Ara h 1 and Ara h 2), which were insoluble in acidic and neutral conditions. Succinylation of the allergens inhibited complex formation, indicating that lysine residues were involved. A 6-fold reduction in IgE binding or allergenic potency of the extract was observed after treatment with phytic acid. It was concluded that phytic acid formed insoluble complexes with the major peanut allergens, and resulted in a peanut extract with reduced allergenic potency. Application of phytic acid to a peanut butter slurry presented a similar result, indicating that phytic acid may find use in the development of hypoallergenic peanut-based products.

Allergenic properties of roasted peanut allergens may be reduced by peroxidase.

Peanut allergy is a public health issue. The culprits are the peanut allergens. Reducing the allergenic properties of these allergens or proteins will be beneficial to allergic individuals. In this study, the objective was to determine if peroxidase (POD), which catalyzes protein cross-linking, reduces the allergenic properties of peanut allergens. In the experiments, protein extracts from raw and roasted defatted peanut meals at pH 8 were incubated with and without POD in the presence of hydrogen peroxide at 37 degrees C for 60 min. The POD-treated and untreated samples were then analyzed by SDS-PAGE, western blots, and competitive inhibition ELISA. IgE binding or allergenicity was determined in blots and ELISA. Results showed that POD treatment had no effect on raw peanuts with respect to protein cross-linking. However, a significant decrease was seen in the levels of the major allergens, Ara h 1 and Ara h 2, in roasted peanuts after POD treatment. Also, polymers were formed. Despite this, a reduction in IgE binding was observed. It was concluded that POD induced the cross-linking of mainly Ara h 1 and Ara h 2 from roasted peanuts and that, due to POD treatment, IgE binding was reduced. The finding indicates that POD can help reduce the allergenic properties of roasted peanut allergens.

Linking peanut allergenicity to the processes of maturation, curing, and roasting.

The processes of peanut maturation, curing, and roasting are known to have an important role in peanut flavors. One of these processes (i.e., roasting) has been found to have an effect on allergenicity. To determine if the other processes (i.e., maturation and curing) affect allergenicity, mature and immature roasted peanuts and peanuts cured at different temperatures (35-77 degrees C) were, respectively, tested for IgE binding and advanced glycation end adducts (AGEs). Peanuts with and without stress proteins, which are associated with peanut maturation and curing, were also tested. Results showed that mature roasted peanuts exhibited a higher IgE binding and AGEs level than immature roasted peanuts. Curing temperatures between 35 and 60 degrees C gave no difference in the profiles. However, a higher curing temperature (i.e., 77 degrees C) exhibited a profile of higher levels of AGEs and IgE binding. These levels were higher in peanuts with stress proteins than without stress proteins. Roasting increased stress protein level and IgE binding. From these results, the processes of maturation and curing, in conjunction with roasting, may be associated with allergenicity, suggesting that these processes may lead to changes in the allergenic properties of peanuts.

The major peanut allergen, Ara h 2, functions as a trypsin inhibitor, and roasting enhances this function.

BACKGROUND: The widespread use of peanut products, the severity of the symptoms, and its persistence in afflicted individuals has made peanut allergy a major health concern in western countries such as the United States, United Kingdom, and Canada. In a previous study, the authors showed that the allergenic properties of peanut proteins are enhanced as a result of thermal processing. OBJECTIVE: The purpose of this investigation was to determine whether any specific functions are associated with the major peanut allergen, Ara h 2, and whether the functionality of this protein is influenced by processing. An assay was developed and used to assess structure/function changes in Ara h 2 induced by roasting and the effect of these alterations on the allergenic properties of this major peanut allergen. METHODS: A protein domain homology search was used to determine possible functions for Ara h 2. One of the putative functions (protease inhibition) was tested by means of appropriate enzyme assays and protein gel electrophoresis. Circular dichroism was used to compare the structural properties of Ara h 2 purified from raw and roasted peanuts. RESULTS: Ara h 2 purified from peanuts is homologous to and functions as a trypsin inhibitor. Roasting caused a 3.6-fold increase in trypsin inhibitory activity. Functional and structural comparison of the Ara h 2 purified from roasted peanuts to native and reduced Ara h 2 from raw peanuts revealed that the roasted Ara h 2 mimics the behavior of native Ara h 2 in a partially reduced form. CONCLUSIONS: The data indicate that thermal processing might play an important role in enhancing the allergenic properties of peanuts. Not only has it previously been shown to affect the structural and allergic properties of peanut proteins but also, for the first time, the functional characteristics of an allergen. These structural and functional alterations are likely to influence the allergenicity of peanuts.

The functional effectiveness of reprocessed rice bran as an ingredient in bakery products.

Rice bran, as a coproduct of the rice milling industry, is yet to be efficiently utilized for human consumption. Despite its excellent nutrition, its hypoallergenicity and recently claimed nutraceutical properties, it is mainly utilized for animal feed or simply discharged. It is of interest to incorporate this healthy ingredient back into our diet. In these studies, rice bran was processed by drum-drying and pin-milling. This processing step increased hydration capacity and removed grittiness by decreasing mean particle size from 444 to 72 microns and producing a desirable monomodal size distribution. There are no reported studies addressing differences in rice bran composition in food applications and specifically their effect on bread quality. Thus, we were interested in examining the functional properties of bread made with processed full-fat (FFRB) and defatted (DFRB) bran from three cultivars (long, medium and short grain rice) and to compare them to a control. For 10% and 20% replacements of wheat flour, respectively, loaf volume increased 2% for FFRB and decreased 6% for DFRB and decreased by 6% for FFRB and 17% for DFRB. Loaf volume was highest with medium rice bran and this was attributed to its lowest fiber content and highest starch content among three varieties. Texture profile analysis showed no significant differences as far as cohesiveness and springiness, but bread hardness, gumminess and chewiness increased with increased levels of rice bran and was higher for DFRB bread than for FFRB. Measurements of texture determined that there was no detrimental effect in adding 10% FFRB to the bread and a very slight hardening of the loaves with the 20% FFRB, when compared to the control. It was found that FFRB gave better textural characteristics than DFRB overall and differences amongst different rice bran varieties were not significant.

High-oleic peanuts are not different from normal peanuts in allergenic properties.

High-oleic peanuts are known for a high content of oleic fatty acid. However, it is not known whether high-oleic peanuts are different from normal chemistry peanuts in levels of allergenicity and end-product adducts (i.e., products cross-linked with proteins). For this purpose, four different peanut cultivars (Florunner, Georgia Green, NC 9, and NC 2) were evaluated and compared with high-oleic peanuts (SunOleic 97R). Adducts such as AGE/CML from Maillard reactions and MDA/HNE from lipid oxidation were determined, respectively, in ELISA, using polyclonal antibodies. Allergenicity was determined based on IgE binding and T-cell proliferation. Results showed that raw high-oleic peanuts were not different from normal peanuts in adduct levels. After roasting, CML and HNE levels remained unchanged, but an increased and similar amounts of AGE adducts were found in all peanuts. MDA also increased but not in high-oleic peanuts. This suggests that high-oleic peanuts are more stable to lipid oxidation than others during heating. Despite this, high-oleic peanuts did not differ from normal peanuts in IgE binding and T-cell proliferation. It was concluded that a high content of oleic fatty acid has no effect on peanut allergenicity and that high-oleic peanuts do not give a higher or lower risk of allergy than normal peanuts.