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1.
Biotechnol Bioeng ; 121(3): 1090-1101, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38151902

RESUMO

Protein A capture chromatography remains a high-cost and relatively low-productivity step for downstream processing of monoclonal antibodies. As bioprocessing transitions toward intensified processes, maximizing the efficiency of individual steps is key to achieving economic targets. This study was performed to assess the impact of inline concentration of clarified cell culture fluid (CCF), using single-pass tangential flow filtration, on protein A chromatography purification productivity. CCF with varying levels of impurities and turbidity were obtained dependent upon the clarification method. These CCFs were concentrated and processed over a protein A capture step. Productivity increases of 1.8- to 2.6-fold were achieved as compared to a protein A capture step with no CCF concentration. Achieving such targeted improvements requires careful consideration of the multiple components in the clarification strategy before implementation.


Assuntos
Anticorpos Monoclonais , Proteína Estafilocócica A , Animais , Cricetinae , Proteína Estafilocócica A/química , Anticorpos Monoclonais/química , Cromatografia , Técnicas de Cultura de Células/métodos , Filtração/métodos , Cricetulus , Células CHO
2.
Cult Health Sex ; : 1-17, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38478394

RESUMO

Abortion was decriminalised in Northern Ireland in October 2019. Following decriminalisation, the new regulations set out legal provision for abortion up until 12 weeks, with conditions thereafter. This cross-sectional descriptive survey, conducted in late 2019 in Northern Ireland, gathered the views of health professionals on decriminalisation, and their willingness to provide abortion services. This article provides a thematic analysis of answers to narrative questions from the online survey, and identifies priority areas of engagement with healthcare professionals. We assess how healthcare professional roles and responsibilities, abortion procedures, the foetus, and women and pregnant people were discursively constructed by respondents who are willing or unwilling to provide abortion services in Northern Ireland. We identify a narrow understanding of 'harm', and gendered norms of women as irresponsible or duplicitous, as inhibitory factors to the normalisation of abortion services in Northern Ireland.

3.
BMC Med Inform Decis Mak ; 24(1): 32, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38308286

RESUMO

BACKGROUND: Patients with advanced cancer who no longer have standard treatment options available may decide to participate in early phase clinical trials (i.e. experimental treatments with uncertain outcomes). Shared decision-making (SDM) models help to understand considerations that influence patients' decision. Discussion of patient values is essential to SDM, but such communication is often limited in this context and may require new interventions. The OnVaCT intervention, consisting of a preparatory online value clarification tool (OnVaCT) for patients and communication training for oncologists, was previously developed to support SDM. This study aimed to qualitatively explore associations between patient values that are discussed between patients and oncologists during consultations about potential participation in early phase clinical trials before and after implementation of the OnVaCT intervention. METHODS: This study is part of a prospective multicentre nonrandomized controlled clinical trial and had a between-subjects design: pre-intervention patients received usual care, while post-intervention patients additionally received the OnVaCT. Oncologists participated in the communication training between study phases. Patients' initial consultation on potential early phase clinical trial participation was recorded and transcribed verbatim. Applying a directed approach, two independent coders analysed the transcripts using an initial codebook based on previous studies. Steps of continuous evaluation and revision were repeated until data saturation was reached. RESULTS: Data saturation was reached after 32 patient-oncologist consultations (i.e. 17 pre-intervention and 15 post-intervention). The analysis revealed the values: hope, perseverance, quality or quantity of life, risk tolerance, trust in the healthcare system/professionals, autonomy, social adherence, altruism, corporeality, acceptance of one's fate, and humanity. Patients in the pre-intervention phase tended to express values briefly and spontaneously. Oncologists acknowledged the importance of patients' values, but generally only gave 'contrasting' examples of why some accept and others refuse to participate in trials. In the post-intervention phase, many oncologists referred to the OnVaCT and/or asked follow-up questions, while patients used longer phrases that combined multiple values, sometimes clearly indicating their weighing. CONCLUSIONS: While all values were recognized in both study phases, our results have highlighted the different communication patterns around patient values in SDM for potential early phase clinical trial participation before and after implementation of the OnVaCT intervention. This study therefore provides a first (qualitative) indication that the OnVaCT intervention may support patients and oncologists in discussing their values. TRIAL REGISTRATION: Netherlands Trial Registry: NL7335, registered on July 17, 2018.


Assuntos
Tomada de Decisões , Neoplasias , Humanos , Estudos Prospectivos , Neoplasias/terapia , Tomada de Decisão Compartilhada , Comunicação , Participação do Paciente
4.
J Environ Manage ; 358: 120781, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38608570

RESUMO

Transforming global agricultural waste into eco-friendly products like industrial enzymes through bioconversion can help address sustainability challenges aligning with the United Nations' Sustainable Development Goals. Present study explored the production of high-yield food-grade cellulolytic enzymes from Trichoderma reesei MTCC 4876, using a novel media formulation with a combination of waste sorghum grass and cottonseed oil cake (3:1). Optimization of physical and environmental parameters, along with the screening and optimization of media components, led to an upscaled process in a novel 6-L solid-state fermentation (SSF)-packed bed reactor (PBR) with a substrate loading of 200 g. Saturated forced aeration proved crucial, resulting in high fungal biomass (31.15 ± 0.63 mg glucosamine/gm dry fermented substrate) and high yield cellulase (20.64 ± 0.36 FPU/g-ds) and xylanase (16,186 ± 912 IU/g-ds) production at an optimal airflow rate of 0.75 LPM. The PBR exhibited higher productivity than shake flasks for all the enzyme systems. Microfiltration and ultrafiltration of the crude cellulolytic extract achieved 94% and 71% recovery, respectively, with 13.54 FPU/mL activity in the cellulolytic enzyme concentrate. The concentrate displayed stability across wide pH and temperature ranges, with a half-life of 24.5-h at 50 °C. The cellulase concentrate, validated for food-grade safety, complies with permissible limits for potential pathogens, heavy metals, mycotoxins, and pesticide residue. It significantly improved apple juice clarity (94.37 T%) by reducing turbidity (21%) and viscosity (99%) while increasing total reducing sugar release by 63% compared with untreated juice. The study also highlighted the potential use of lignin-rich fermented end residue for fuel pellets within permissible SOx emission limits, offering sustainable biorefinery prospects. Utilizing agro wastes in a controlled bioreactor environment underscores the potential for efficient large-scale cellulase production, enabling integration into food-grade applications and presenting economic benefits to fruit juice industries.


Assuntos
Reatores Biológicos , Fermentação , Sucos de Frutas e Vegetais , Hypocreales , Sorghum , Sorghum/metabolismo , Sucos de Frutas e Vegetais/análise , Celulase/metabolismo , Malus
5.
Prep Biochem Biotechnol ; : 1-15, 2024 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-38491924

RESUMO

An integrated approach involving response surface methodology (RSM) and artificial neural network-ant-colony hybrid optimization (ANN-ACO) was adopted to develop a bioprocess medium to increase the yield of Bacillus cereus neutral protease under submerged fermentation conditions. The ANN-ACO model was comparatively superior (predicted r2 = 98.5%, mean squared error [MSE] = 0.0353) to RSM model (predicted r2 = 86.4%, MSE = 23.85) in predictive capability arising from its low performance error. The hybrid model recommended a medium containing (gL-1) molasses 45.00, urea 9.81, casein 25.45, Ca2+ 1.23, Zn2+ 0.021, Mn2+ 0.020, and 4.45% (vv-1) inoculum, for a 6.75-fold increase in protease activity from a baseline of 76.63 UmL-1. Yield was further increased in a 5-L bioreactor to a final volumetric productivity of 3.472 mg(Lh)-1. The 10.0-fold purified 46.6-kDa-enzyme had maximum activity at pH 6.5, 45-55 °C, with Km of 6.92 mM, Vmax of 769.23 µmolmL-1 min-1, kcat of 28.49 s-1, and kcat/Km of 4.117 × 103 M-1 s-1, at 45 °C, pH 6.5. The enzyme was stabilized by Ca2+, activated by Zn2+ but inhibited by EDTA suggesting that it was a metallo-protease. The biomolecule significantly clarified orange and pineapple juices indicating its food industry application.

6.
J Sci Food Agric ; 104(6): 3532-3542, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38146066

RESUMO

BACKGROUND: Flavor is considered as a key quality attribute of fruit juice affecting consumer acceptance. During processing, the flavor loss of cloudy juice always occurs due to the variations of juice cloud particles. Pectin, a major component of cloud particles, plays an important role in cloud stability. In this work, we focused on the effects of variation of three pectin fractions caused by gentle centrifugation and clarification on the physicochemical properties, volatile content and sensory profile of heat-sterilized muskmelon cloudy juice. RESULTS: Centrifugation treatment reduced the total soluble solids and viscosity of cloudy juice and increased cloud stability. With centrifugation increased, the contents of most monosaccharides in the three pectin fractions were reduced. Most aroma-active aldehydes and alcohols, such as (2E,6Z)-nonadienal, 1-octen-3-ol and (E)-non-2-enal, after gentle centrifugation and clarification, were maintained, but most esters were decreased. The volatile compositions were highly related to the three pectin fractions. The addition of chelator-soluble pectin and sodium carbonate-soluble pectin could decrease the formation of dimethyl trisulfide and dimethyl disulfide in clarified juice, thereby improving the sensory profile. CONCLUSION: The results suggested that endogenous chelator-soluble pectin and sodium carbonate-soluble pectin can be used in heat-sterilized fruit juice to improve flavor quality, with an emphasis on a significant reduction in volatile sulfur compounds. © 2023 Society of Chemical Industry.


Assuntos
Carbonatos , Temperatura Alta , Pectinas , Pectinas/análise , Frutas/química , Quelantes
7.
Z Rheumatol ; 83(5): 341-353, 2024 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-38634905

RESUMO

Fever is a frequent and important symptom in patients with rheumatological diseases and can be an expression of activity of the underlying rheumatological disease. There is great variability in the incidence of fever as a symptom of the disease between individual diseases. The growing understanding of the molecular signatures of the diseases can help to explain these discrepancies: A genetic overactivation of potently pyrogenic cytokines is the reason why fever is nearly always present in autoinflammatory syndromes. In contrast, fever is less common in polyarthritis and myositis and mostly limited to severe courses of disease. In the diagnostic work-up of fever, frequent differential diagnoses, such as infections, malignancies, side effects of drugs and hypersensitivity reactions should be considered. This article provides an overview of the physiology of the development of fever, describes the relevance of fever in individual rheumatological diseases and proposes a workflow for the clinical clarification of rheumatological patients who present with fever.


Assuntos
Febre , Doenças Reumáticas , Humanos , Doenças Reumáticas/complicações , Doenças Reumáticas/diagnóstico , Febre/diagnóstico , Febre/etiologia , Diagnóstico Diferencial , Febre de Causa Desconhecida/etiologia , Febre de Causa Desconhecida/diagnóstico
8.
Biotechnol Bioeng ; 2023 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-37334463

RESUMO

The intensification of industrial biopharmaceutical production and the integration of process steps pave the way for patients to access affordable treatments. The predominantly batchwise biomanufacturing of established cell clarification technologies, stainless steel disc stack centrifugation (DSC) and single-use (SU) depth filtration (DF), pose technological and economical bottlenecks, that include low biomass loading capacities and low product recoveries. Therefore, a novel SU-based clarification platform was developed combining fluidized bed centrifugation (FBC) with integrated filtration. The feasibility of this approach was investigated for high cell concentration with more than 100E6 cells/mL. Furthermore, scalability to 200 L bioreactor scale was tested for moderate cell concentrations. In both trials, low harvest turbidities (4 NTU) and superior antibody recoveries (95%) were achieved. The impact on the overall economics of industrial SU biomanufacturing using an up-scaled FBC approach was compared with DSC and DF technologies for different process parameters. As a result, the FBC showed to be the most cost-effective alternative for annual mAb production below 500 kg. In addition, the FBC clarification of increasing cell concentrations was found to have minimal impact on overall process costs, in contrast to established technologies, demonstrating that the FBC approach is particularly suitable for intensified processes.

9.
Biotechnol Bioeng ; 120(7): 1882-1890, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36929487

RESUMO

A number of studies have demonstrated that depth filtration can provide significant adsorptive removal of host cell proteins (HCP), but there is still considerable uncertainty regarding the underlying factors controlling HCP binding. This study compared the binding characteristics of two fine grade depth filters, the X0SP (polyacrylic fiber with a synthetic silica filter aid) and X0HC (cellulose fibers with diatomaceous earth (DE) as a filter aid), using a series of model proteins with well-defined physical characteristics. Protein binding to the X0SP filter was dominated by electrostatic interactions with greatest capacity for positively-charged proteins. In contrast, the X0HC filter showed greater binding of more hydrophobic proteins although electrostatic interactions also played a role. In addition, ovotransferrin showed unusually high binding capacity to the X0HC, likely due to interactions with metals in the DE. Scanning Electron Microscopy with Energy Dispersive Spectroscopy was used to obtain additional understanding of the binding behavior. These results provide important insights into the physical phenomena governing HCP binding to both fully synthetic and natural (cellulose + DE) depth filters.


Assuntos
Terra de Diatomáceas , Dióxido de Silício , Terra de Diatomáceas/química , Filtração/métodos , Adsorção , Proteínas/química
10.
Biotechnol Bioeng ; 120(9): 2672-2684, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37148527

RESUMO

Virus-like particles-based vaccines have been gaining interest in recent years. The manufacturing of these particles includes their production by cell culture followed by their purification to meet the requirements of its final use. The presence of host cell extracellular vesicles represents a challenge for better virus-like particles purification, because both share similar characteristics which hinders their separation. The present study aims to compare some of the most used downstream processing technologies for capture and purification of virus-like particles. Four steps of the purification process were studied, including a clarification step by depth filtration and filtration, an intermediate step by tangential flow filtration or multimodal chromatography, a capture step by ion exchange, heparin affinity and hydrophobic interaction chromatography and finally, a polishing step by size exclusion chromatography. In each step, the yields were evaluated by percentage of recovery of the particles of interest, purity, and elimination of main contaminants. Finally, a complete purification train was implemented using the best results obtained in each step. A final concentration of 1.40 × 1010 virus-like particles (VLPs)/mL with a purity of 64% after the polishing step was achieved, with host cell DNA and protein levels complaining with regulatory standards, and an overall recovery of 38%. This work has resulted in the development of a purification process for HIV-1 Gag-eGFP virus-like particles suitable for scale-up.


Assuntos
HIV-1 , Vacinas de Partículas Semelhantes a Vírus , Vacinas de Partículas Semelhantes a Vírus/genética , Cromatografia em Gel , Filtração/métodos , Técnicas de Cultura de Células
11.
Crit Rev Food Sci Nutr ; : 1-21, 2023 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-37578772

RESUMO

Sweet sorghum is a promising biomaterial, considering its nutritional and energy value, unpretentiousness in cultivation and its promising economic parameters of processing. The concentrate of sweet sorghum juice is an outstanding material for food purposes, meeting the emerging trends of the industry. This review presents data on the physicochemical properties of sweet sorghum juice and sirup, as well as technological details on the processes of its pretreatment, clarification, and concentration. Physicochemical properties of raw juice of sweet sorghum, as well as purified juice and sirup, are discussed in terms of material pretreatment, methods of clarification and concentration, and storage conditions. Comprehensive theoretical principles, methodological details and explanations of the consistency of sweet sorghum juice processing are given. This work focuses entirely on the relationship between sweet sorghum juice treatment methods and its composition and provides versatile source of information for food science community, farmers, and entrepreneurs.

12.
Int J Legal Med ; 137(3): 863-873, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36781444

RESUMO

As part of a third-party funded project, expert opinions according to the Istanbul Protocol (IP) standards were compiled in Germany on a larger scale for the first time. The assessment process was initiated for 130 project participants. Statistical analysis on numerous variables was performed to test the impact of the expert opinions, foremost of the forensic medical expert opinions, on the individuals' asylum proceedings. The variables were drawn from forensic medical expert opinions and reports of findings, questionnaires for the study participants' counsellors in the project and a query on the asylum status of the study participants. Regression analysis and bivariate analysis on two dependent variables-subjective impact on the asylum procedure from the counsellors' point of view and objective change in the asylum status-were performed to test for an influence on asylum procedures. No statistically significant results were obtained for the objective change of the study participants' asylum status. For the subjective dependent variable, a positive prediction was possible when simultaneously controlling for the independent variables introduction of a forensic medical expert opinion and highest IP grade; a negative prediction was possible when simultaneously controlling for the independent variables introduction of a forensic medical expert opinion and use of IP grading. Apart from the statistical analysis, a positive effect of the assessment on the psychosocial well-being of the study participants could be demonstrated. The results differed from other European studies which demonstrated a correlation between the objective outcome of an asylum procedure (asylum status) and, for example, specific types of violence or the number of documented injuries. Differences also occurred in the use of the plausibility grades proposed by the IP, which questions their use in cases in which the reported torture happened a relevant time ago. Therefore, compiling individually worded evaluations instead of using the IP grading system-if possible, by an experienced forensic physician-is recommended in this scenario. Still, the assessment of alleged torture experiences should follow the IP guidelines, since psychological assessments are of especially high importance in cases with healed physical injuries and since the results also demonstrated a positive effect on the psychosocial well-being of the study participants.


Assuntos
Refugiados , Tortura , Humanos , Prova Pericial , Medicina Legal , Alemanha
13.
Reprod Health ; 20(1): 97, 2023 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-37381001

RESUMO

BACKGROUND: From 2018, the International Federation of Gynecologists and Obstetricians (FIGO) implemented the Advocating Safe Abortion project to support national obstetrics and gynecology (Obs/gyn) societies from ten member countries to become leaders of Sexual and Reproductive Health and Rights (SRHR). We share experiences and lessons learnt about using value clarification and attitude transformation (VCAT) and abortion harm reduction (AHR) as strategies for our advocacy engagements. METHODS: The advocacy goal of ending abortion-related deaths followed predefined pathways from an extensive needs assessment prior to the project. These pathways were strengthening capacity of the Obs/gyn society as safe abortion advocates; establishing a vibrant network of partners; transforming social and gender norms; raising awareness of the legal and policy environment regarding abortion, and promoting the generation and use abortion data for evidence-informed policy and practice. Our advocacy targeted multiple stakeholders including media, policy makers judicio-legal, political and religious leaders, health workers and the public. RESULTS: During each engagement, facilitators required audiences to identify what roles they can play along the continuum of strategies that can reduce maternal death from abortion complications. The audiences acknowledged abortion complications as a major problem in Uganda. Among the root causes for the abortion context, audiences noted absence of an enabling environment for abortion care, which was characterized by low awareness about the abortion laws and policy, restricted abortion laws, cultural and religious beliefs, poor quality of abortion care services and abortion stigma. CONCLUSION: VCAT and AHR were critical in enabling us to develop appropriate messages for different stakeholders. Audiences were able to recognize the abortion context, distinguish between assumptions, myths and realities surrounding unwanted pregnancy and abortion; recognize imperative to address conflict between personal and professional values, and identify different roles and values which inform empathetic attitudes and behaviors that mitigate abortion harms. The five pathways of the theory of change reinforced each other. Using the AHR model, we delineate strategies and activities which stakeholders could use to end abortion deaths. VCAT enables critical reflection of views, beliefs and values versus professional obligations and responsibilities, and promotes active attitude and behavior change and commitment to end abortion-related deaths.


Assuntos
Aborto Induzido , Aborto Espontâneo , Feminino , Gravidez , Humanos , Redução do Dano , Uganda , Atitude
14.
Reprod Health ; 20(1): 180, 2023 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-38057896

RESUMO

BACKGROUND: A community of practice (CoP) is defined as a group of people who share a concern, set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis. The paper presents a case study on the design, implementation and management of a CoP. The objective is to share experiences, opportunities, challenges and lessons learnt in using digital platforms for clinical mentorships to establish a CoP that promotes enhanced service provision of abortion care. METHODS: We employed competence-based training and ongoing virtual mentorship for abortion care, employing the abortion harm reduction model, and using several digital platforms to create and nurture community of practice for abortion care. Using the Capability-Opportunity-Motivation for Behavior (COM-B) model and textual data analysis, we evaluated the performance of the CoP as a tool to support abortion care, using data from in-depth interviews and information shared on the platforms. The data was analyzed by thematic analysis using text data analytical approach. RESULTS: CoPs have much unrealized potential for networking to improve abortion care, as they are more inclusive, interactive and equalizing than typical webinars, yet less expensive and can complement (though not replace) physical mentorships. CoPs' focus on sharing best practices and creating new knowledge to advance professional practice, faces challenges of maintaining regular interaction on an ongoing basis. CoP members need to share a passion for their practice and mutual trust is key to success. CONCLUSION: Though it faced initial challenges of connectivity, and limited interaction, the CoP approach using digital platforms promoted shared experiences, personal connections, communication, collaboration and application of knowledge for improved abortion care.


Assuntos
Comunicação , Humanos , Uganda , Serviços de Saúde Comunitária , Pessoal de Saúde
15.
J Adv Nurs ; 2023 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-38041594

RESUMO

AIM: To examine the concept of preparedness over time in research with informal caregivers of older adults. DESIGN: Concept analysis. METHODS: Rodgers' evolutionary method of concept analysis was used to guide this theoretical paper due to the dynamic nature of preparedness, which is influenced by both context and time. Using Rodgers' inductive approach, concept elements were derived from a content analysis of included studies. In the final step, to generate hypotheses and implications regarding the concept, the conceptual structure of preparedness of informal caregivers of older adults was connected to a theoretical problem in the nursing discipline using the Caregiving Stress Process Framework. DATA SOURCES: Four databases (EBSCO CINAHL, Ovid MEDLINE, Ovid PsycINFO and Scopus) were searched in November 2022 and updated in September 2023. No date limits were set for searching, as the intent was to analyse possible variations of the concept over time. RESULTS: The attributes of preparedness include self-confidence, having knowledge, skills and abilities to perform daily tasks, handling emotions and developed over time. These attributes can be compared with the stressors outlined in the Caregiving Stress Process Framework (i.e., the moment the caregiver identifies some 'stressor'; something that prevents them from feeling confident in their preparedness). CONCLUSION: The concept of preparedness of informal caregivers of older adults is defined as caregiver's self-confidence about their current competence related to the knowledge, skills and abilities to perform daily tasks, and to handle emotions over time. To link the concept to a theoretical perspective, we propose adaptations to a well-known theory, the Caregiving Stress Process Framework. Future research on caregiving preparedness needs to avoid circular definitions and work with the attributes of preparedness to support caregivers. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This paper contributes to the development of interventions that focus on the health and preparedness of informal caregivers of older adults. Clarifying the concept of preparedness helps nurses to support caregivers since it is then known which aspects are included in the preparedness of caregivers (e.g., daily tasks and handling emotions). A more fulsome understanding of preparedness supports us to see beyond stressors of caregiving. IMPACT: This study addresses informal caregivers of older adults' preparedness to provide care. We synthesized existing definitions that have been used in research with this population to propose a robust conceptualization of the concept of preparedness, which contributes to better understanding of how preparedness can be supported. REPORTING METHOD: We were unable to locate a reporting method related to this kind of work (concept analysis). PATIENT OR PUBLIC CONTRIBUTION: Not applicable as no new data generated.

16.
Behav Med ; 49(2): 137-150, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34791986

RESUMO

In this study an interactive decision aid (DA) for men diagnosed with localized prostate cancer was adapted, extended and pre-tested. The DA's prototype was based on a literature review and other empirically tested DAs. Semi-structured interviews with 12 men (age 65-80) diagnosed with localized prostate cancer were conducted to get feedback on content, usability, and the DA's layout. The interviews were analyzed using thematic analysis and themes were identified using deductive and inductive coding. Participants found the accessibility of the information and the explicit values clarification tool helpful. Four themes were identified: (1) usability and design, (2) content and knowledge, (3) deciding factors of decision-making, and (4) social support. Participants valued receiving extensive and realistic information on surgery/radiation therapy side effects and getting unbiased presentations of treatment options. Following the thematic analysis, the DA was revised and tested in a survey among 11 newly diagnosed prostate cancer patients (age 60-74). The participants valued the DA and found it helpful when making a treatment decision, and all reported that they would recommend it to others making a prostate cancer treatment decision. The DA is currently being tested in a randomized clinical trial (RCT). This is the first DA developed for prostate cancer patients in Iceland and if the results of the RCT show that it is more effective than standard care in assisting newly diagnosed patients with their treatment decision, the DA can be easily translated and adapted to cultures similar to Iceland such as the Nordic countries.


Assuntos
Técnicas de Apoio para a Decisão , Neoplasias da Próstata , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Islândia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Inquéritos e Questionários , Literatura de Revisão como Assunto
17.
Compr Rev Food Sci Food Saf ; 22(6): 4190-4216, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37615977

RESUMO

The consumption of fruit juices has been increasingly growing all over the world. The clarification process is considered as one of the most important stages in fruit juice production, which can provide the products with desired clear visual appearance. Nowadays, the tendency of consumers to use the natural-clarified fruit juices encourages the researchers to allocate much attention on utilization of natural clarifying agents to clarify different fruit juices. This review article has first introduced the most frequent causes of turbidity in fruit juices including polysaccharides (i.e., cellulose, hemicelluloses, lignin, starch, and pectic substances), proteins and polyphenols (especially tannins) as well as their removal mechanisms. After that, a comprehensive summary of research on natural fining agents, including clay minerals, polysaccharides, proteins, enzymes (free and immobilized forms), and activated carbon is provided with a focus on their application in the juice clarification process. The chemical composition of natural substances, their efficiency on reduction of turbidity-causing compounds and the changes in properties of clarified juices such as turbidity (clarity), total phenolic content, total anthocyanins, viscosity, and sensory evaluation followed by their stability during the storage have been deeply discussed.


Assuntos
Antocianinas , Sucos de Frutas e Vegetais , Antocianinas/análise , Frutas/química , Manipulação de Alimentos , Polissacarídeos
18.
Clin Psychol Psychother ; 30(1): 64-72, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35776063

RESUMO

OBJECTIVE: Histrionic personality disorder (HPD) with a lifetime prevalence rate of 1.8% is an under-researched psychiatric diagnosis. The present study therefore aimed to investigate both the processes and outcomes of psychotherapy for HPD in a non-controlled study. METHODS: A total of 159 patients diagnosed with HPD were recruited and received clarification-oriented psychotherapy. Sessions 15, 20, and 25 were video-recorded and analysed using the Process-Content-Relationship Scale. Therapy outcome was assessed with symptom measures at intake and discharge. Hierarchical linear modelling was applied to estimate the changes in the psychotherapeutic outcome and associations with patient and therapist process developments. RESULTS: Improvements in relationship processes of patients and therapists were systematically related to outcome while only partial relationships were found on the levels of process and content. CONCLUSION: The present study represents the first systematic insight into core changes in patients with HPD undergoing psychotherapy.


Assuntos
Transtorno da Personalidade Histriônica , Psicoterapia , Humanos , Transtorno da Personalidade Histriônica/diagnóstico , Transtorno da Personalidade Histriônica/psicologia , Resultado do Tratamento
19.
J Food Sci Technol ; 60(7): 2001-2011, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37206425

RESUMO

Microfiltration of citrus fruit juices using membrane technology is a promising method for clarification without losing their inherent properties to extend their shelf life. The present work discusses the development of a tubular ceramic microfiltration membrane and its performance in clarifying two kinds of citrus fruit juices, mandarin and sweet orange. The membrane was prepared by the extrusion method from indigenous bentonite clay, exhibited a porosity of 37% with 0.11 µm pore size, and possessed adequate flexural strength of 18 MPa. The fabricated membrane's potential was evaluated by conducting the tangential filtration of both centrifuged and enzyme-treated centrifuged fruit juices. Also, the applied pressure (68.94-344.7 kPa) and crossflow rate (110-150 Lph) were varied to study the clarified juice properties. At low operating conditions, the highest clarity of the juices was identified despite low permeate flux. The desired properties of juices, including pH, citric acid content, and total soluble solids, were unaffected by pretreatment and tangential membrane filtration, whereas the pectin content, which reduces the juice quality, was eliminated entirely. Furthermore, fouling analysis was carried out using Hermia's models, and cake filtration was identified to be dominant for both juices. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05734-y.

20.
BMC Microbiol ; 22(1): 145, 2022 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-35610561

RESUMO

BACKGROUND: Bacterial pectinase is an enzyme that could be employed in numerous sectors to break down pectin polysaccharide compounds. The goal of this study is to find pectinase-producing bacteria in avocado peel waste and see if the pectinase enzyme produced can be used to make fruit juice clarification. RESULTS: The researchers isolated four different bacterial strains from avocado peel waste samples. The potential two bacterial isolates that were identified as being Serratia marcescens and Lysinibacillus macrolides. Finally, the analysis of pectinase production and its application in fruit juice clarification were performed using one of the bacterial strains of Serratia marcescens. The clear apple, lemon, and mango juices were further processed to assess each juice's properties. The highest antioxidant activity was recorded in lemon juice samples. The lemon juice showed the highest total titratable acidity and total phenol content. Apple juices contained the highest total soluble solids, reducing sugar content, and viscosity and the mango juices have the maximum pH value recorded. CONCLUSIONS: The pectinase isolated from the bacterium Serratia marcescens could clear fruit juices. This pectinase needs to be studied more to make sure it works better in the fruit industry and other businesses.


Assuntos
Malus , Persea , Frutas/química , Sucos de Frutas e Vegetais , Poligalacturonase , Serratia marcescens
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