Nucleosomes and neutrophil extracellular traps in septic and burn patients.

NETosis is a host defense mechanism associated with inflammation and tissue damage. Experimental models show that platelets and von Willebrand factor (VWF) are key elements for intravascular NETosis. We determined NETosis in septic and burn patients at 1 and 4days post-admission (dpa). Nucleosomes were elevated in patients. In septics, they correlated with Human Neutrophil Elastase (HNE)-DNA complexes and SOFA score at 1dpa, and were associated with mortality. Patient's neutrophils had spontaneous NETosis and were unresponsive to stimulation. Although platelet P-selectin and TNF-α were increased in both groups, higher platelet TLR-4 expression, VWF levels and IL-6 were found in septics at 1dpa. Neither platelet activation markers nor cytokines correlated with nucleosomes or HNE-DNA. Nucleosomes could be indicators of organ damage and predictors of mortality in septic but not in burn patients. Platelet activation, VWF and cytokines do not appear to be key mediators of NETosis in these patient groups.

Evaluating the impact of accreditation on Brazilian healthcare organizations: A quantitative study.

OBJECTIVE: The aim of this study was to evaluate the impact of accreditation programs on Brazilian healthcare organizations. DESIGN: A web-based questionnaire survey was undertaken between February and May 2016. SETTING: Healthcare organizations from the Federal District and from 18 Brazilian states. PARTICIPANTS: The quality managers of 141 Brazilian healthcare organizations were the main respondents of the study. INTERVENTION: The questionnaire was applied to not accredited and accredited organizations. MAIN OUTCOME MEASURES: The main outcome measures were patient safety activities, quality management activities, planning activities-policies and strategies, patient involvement, involvement of professionals in the quality programs, monitoring of patient safety goals, organizational impact and financial impacts. RESULTS: The study identified 13 organizational impacts of accreditation. There was evidence of a significant and moderate correlation between the status of accreditation and patient safety activities, quality management activities, planning activities-policies and strategies, and involvement of professionals in the quality programs. The correlation between accreditation status and patient involvement was significant but weak, suggesting that this issue should be treated with a specific policy. The impact of accreditation on the financial results was not confirmed as relevant; however, the need for investment in the planning stage was validated. CONCLUSIONS: The impact of accreditation is mainly related to internal processes, culture, training, institutional image and competitive differentiation.

Developing Core/Shell Capsules Based on Hydroxypropyl Methylcellulose and Gelatin through Electrodynamic Atomization for Betalain Encapsulation.

Betalains are bioactive compounds with remarkable functional and nutritional activities for health and food preservation and attractiveness. Nevertheless, they are highly sensitive to external factors, such as oxygen presence, light, and high temperatures. Therefore, the search for new structures, polymeric matrices, and efficient methods of encapsulation of these compounds is of great interest to increase their addition to food products. In this work, betalains were extracted from red beetroot. Betacyanin and betaxanthin contents were quantified. Subsequently, these compounds were successfully encapsulated into the core of coaxial electrosprayed capsules composed of hydroxypropyl methylcellulose (HPMC) and gelatin (G). The effect of incorporating the carbohydrate and the protein both in the core or shell structures was studied to elucidate the best composition for betalain protection. Morphological, optical, and structural properties were analyzed to understand the effect of the incorporation of the bioactive compounds in the morphology, color, and chemical interactions between components of resulting electrosprayed capsules. The results of the thermogravimetric and encapsulation efficiency analysis coincided that the incorporation of beetroot extract in G in the core and HPMC in the shell resulted in the structure with greater betalain protection. The effectiveness of the core/shell structure was confirmed for future food applications.

Effect of Extrusion Temperature and Feed Moisture Content on the Microstructural Properties of Rice-Flour Pellets and Their Impact on the Expanded Product.

Extrusion can lead to an expanded product or to a slightly expanded pellet, known as a third-generation (3G) snack. In this case, expansion occurs subsequently, in an independent thermal device (e.g., oven), out of the extruded pellet. During both processes, several structural changes occur which are linked to processing conditions, including cooking temperature, screw speed, formulation, and initial moisture content. However, a clear relationship between processing variables and the structure of pellets and expanded products has not yet been identified. Accordingly, this work aimed to study the effect of extrusion temperature (110, 135, and 150 °C) and moisture content (27, 29, and 31%) in rice-flour pellets and their microwave expansion, through a microstructural approach using micro-CT. The results showed that the lowest moisture content (27%) and the highest extrusion temperature (150 °C) led to the highest pellet volume and the highest wall thickness, which in turn led to the highest expansion after microwave heating (50 s, 800 W). Interestingly, no significant differences were observed when analyzing the ratio between the volume of the expanded products and the volume of the pellet (~2.4) when using the different processing conditions.

Evaluating the ability of different characterization parameters to describe the surface of fried foods.

The objective of this work is to identify surface topography characterization parameters that are capable of discriminating the surfaces of different fried foods. Three fried food model systems with clearly different surfaces were formulated from vital wheat gluten, native wheat starch, and potato flakes. The surfaces were measured with a scanning laser microscope (SLM), and the ability of several parameters to discriminate between them was tested. Two conventional parameters, the root mean square roughness (Sq) and the surface Kurtosis (Sku), were calculated, along with parameters derived from area-scale fractal analysis: smooth-rough crossover (SRC), fractal dimension, and relative area as a function of scale. The coefficient of variation (COV) of Sq, Sku, and SRC and fractal dimension of different sizes of measurement regions were calculated for the surface of the roughest product in order to specify a measurement region that would be sufficiently large to be representative. The size of the representative region was found to be 25 mm². Among the parameters evaluated in this study, the most reliable parameter for discriminating the surfaces of fried foods is the relative area calculated from area-scale fractal analysis.