关键词： concentration   dairy products   freezing   separation   thermolabile compounds  

摘要： Freeze concentration technology is applied to concentrate liquid foods at low temperatures, thus separating pure ice crystals from the final concentrate solution. This method is an interesting alternative to concentrate food with high water levels and significant nutritional value such as dairy products, since several bioactive compounds are reduced when exposed to elevated temperatures. Considered that, this technique may be a great alternative to concentrating and maintaining both nutritional and sensory characteristics of liquid foods. The present review aims to introduce freeze concentration procedures as an eligible choice for conserving dairy products', also addressing its effects on the dairy matrix. Practical Application This study reports the main techniques of freeze concentration applications in dairy products, to be used both on an industrial and laboratory scale, aiming to improve the nutritional quality of the products obtained.

关键词： allied health   clinic   hand therapy   occupational therapy   postoperative   satisfaction  

摘要： Introduction To assist with the increasing orthopaedic workload, an allied health led hand therapy clinic was established to manage people having routine hand surgeries. The aim of this study was to evaluate patient and doctor satisfaction and safety of this alternative service delivery model. Methods Prospective multimethod design evaluation was undertaken by occupational therapists and physiotherapists working in the field of hand therapy. Satisfaction surveys were completed by orthopaedic doctors and patients. Patient outcomes were assessed at 6 weeks post operatively using the Quick Disability of Arm, Shoulder and Hand questionnaire, total active range of motion, Crawford Classification, sensation using light touch and pain with activity utilising Wong Baker FACES (R) Pain Rating Scale. Quantitative satisfaction survey data were analysed and presented as frequencies and percentages with open question responses analysed using a qualitative description approach. All complications and readmissions within a 3-month period were identified and recorded to assess safety of this model of care. Results For the 6-week post-operative review, 81 patients were seen by an allied health professional rather than a doctor. Patient satisfaction was high with 90% of patients satisfied with post-operative care provided by allied health;2% of patients preferred to be seen by a doctor. Doctor satisfaction was also high with 95% of doctors being satisfied and confident with the quality of care provided. A high proportion of patients reported pain 2/10 or less with activity (82.72%), had full sensation (69.14%), excellent range of motion (82.72%), and Quick Disability Arm, Shoulder and Hand scores on average were below 25% indicating minimal functional deficits. Only five patients required doctor involvement post-operatively. Conclusion The allied heath led service delivery model was demonstrated to be safe and have high patient and doctor satisfaction, indicating an acceptable alterna

关键词： Syzygium cumini   Biosorption   Biochar   Adsorption   Dexamethasone  

摘要： The work aims to synthesize and characterize vegetal charcoal (or biochar) from Syzygium cumini (AC-SC), evaluating the adsorption capacity for dexamethasone drug (DEX) removal, using the kinetic and equilibrium adsorption. The samples were characterized by N-2 porosimetry, X-ray diffraction, scanning electron microscopy with energy-dispersive spectroscopy, zeta potential, and zero charge point. Adsorption equilibrium was carried out applying the Langmuir, Freundlich, Redlich-Peterson, Sips, and Toth models, and kinetic adsorption applied the pseudo-first order, pseudo-second order, Elovich, Avrami, and Weber-Morris models. AC-SC showed a heterogeneous and porous surface, negatively charged, crystalline structure, specific surface area of the 2.14 m(2) g(-1) and pH(ZCP) = 7.36. About the effect of the AC-SC concentration, 5.0 g L-1 showed the best DEX removal (53.02%), about the others' concentration (2.0 and 7.5 g L-1). About the equilibrium and kinetic adsorption, the Sips model and pseudo-second order showed the best experimental data adjusted, indicating that the adsorption monolayer was dependent on the ions onto the biosorbent, with a maximum adsorption capacity of 0.744 mg g(-1) after 180 min. Therefore, AC-SC can be used as an alternative material in the removal of organic pollutants, such as drug removal.

关键词： Pain   musculoskeletal   older adults   complementary and alternative medicine   alternative therapies  

摘要： Background: This study describes the use of complementary and alternative medicine (CAM) among older adults who report being hampered in daily activities due to musculoskeletal pain. The characteristics of older adults with debilitating musculoskeletal pain who report CAM use is also examined. Methods: Cross-sectional European Social Survey Round 7 data from 21 countries were examined for participants aged 55years and older, who reported musculoskeletal pain that hampered daily activities in the past 12 months. Results: Of the 4950 older adult participants reporting musculoskeletal pain that hampered daily activities, the majority (63.5%) were from the West of Europe, reported secondary education or less (78.2%), and reported at least one other health-related problem (74.6%). In total, 1657 (33.5%) reported using at least one CAM treatment in the previous year. Manual body-based therapies (MBBTs) were most used, including massage therapy (17.9%) and osteopathy (7.0%). Alternative medicinal systems (AMSs) were also popular with 6.5% using homoeopathy and 5.3% reporting herbal. treatments. A general trend of higher CAM use in younger participants was noted. CAM use was associated with physiotherapy use, female gender, higher levels of education, being in employment and living in West Europe. Those reporting multiple health problems were more likely to use all CAM treatments, except MBBT. Conclusion: A third of older Europeans with musculoskeletal pain report CAM use in the previous 12 months. Certain subgroups with higher rates of CAM use could be identified. Clinicians should comprehensively and routinely assess CAM use among older adults with musculoskeletal pain.

关键词： Neurology   Psychopharmacology   Pharmacotherapy   Neurosciences   Psychiatry  

摘要： Clozapine is the only antipsychotic with proven effectiveness in treatment-resistant schizophrenia. It is usually administered using commercially available oral tablets, but not all patients are willing or able to take medicines in this way. Orodispersible clozapine tablets are available from several manufacturers and may be useful where swallowing solid dosage forms is difficult, or as an aid to observe compliance. Liquid formulations of clozapine can be prepared extemporaneously or purchased commercially, but most preparations are suspensions (clozapine is poorly soluble) and patients may find them unpalatable. The administration of clozapine (suspension or crushed tablets) via enteral feeding tubes (predominantly nasogastric) has been reported both in medically unwell patients and in patients refusing clozapine. Enteral administration is likely to be superseded by intramuscular clozapine, which has recently been re-introduced and is being widely used in some countries. Successful use of this formulation in enforced treatment strategies has been described by several authors with good long-term outcomes when switched to oral treatment. Intramuscular clozapine has also been used in physically ill patients who are unable to take any form of enteral medication. Other methods of delivery (transdermal, nasal) are not yet commercially available, but offer promise of further treatment options for this group of seriously ill patients.

摘要： This article describes an alternative digital approach for fabricating an implant-supported interim prosthesis. An interim prosthesis with an appropriate emergence profile and esthetics was fabricated before surgery and connected to the interim abutment immediately after implantation guided by a prosthetic template. (J Prosthet Dent 2022;127:228-32)

关键词： PEGylation   L-asparaginase   Reducing agents   Pyridine borane   Pegaspargase  

摘要： PEGylation is a reductive alkylation of a protein N-terminal/alpha-amine of protein with mPEG chain by reducing agent. To obtain quantitative and site-specific PEGylation, sodium cyanoborohydride is commonly used as a reducing agent. The reduction process of sodium cyanoborohydride produces highly poisonous hydrogen cyanide, which may render the final product toxic. Herein, we have studied various reducing agents such as dimethylamine borane, triethylamine borane, trimethylamine borane, pyridine borane, morpholine borane, 2-picoline borane, and 5-ethyl-2-methyl-pyridine borane were tested as alternatives to sodium cyanoborohydride for the PEGylation of L-asparaginase. The characterization of reacted pegaspargase was carried out by SDS-PAGE, Western blotting, SEC-HPLC, RP-HPLC, SEC-MALS, CD, enzyme activity, and cell proliferation assays using with lymphoblast cells and MTS/PMS as substrate. Pyridine borane was determined to be the best acceptable reducing agent for PEGylation in terms of purity and activity. As a result, instead of sodium cyanoborohydride, pyridine borane can be employed.

关键词： Layered double hydroxides   Intercalation   5-aminosalicylic acid   Drug delivery  

摘要： Among a great variety of applications, layered double hydroxides (LDH) can be used as drug delivery systems improving the dissolution rate of poorly water-soluble drugs. Different methods, as co-precipitation, ion exchange, reconstitution, among others, can be used in order to intercalate drugs in the LDH interlayer space, such as 5-aminosalicylic acid (5ASA), widely used in the treatment of inflammatory bowel diseases, although it presents low bioavailability and water solubility. The chosen method can determine structural and material properties of the final product, such as crystal size, particle distribution and morphology. This study presents the reconstitution method as an alternative. The samples were characterized by elemental analysis, X-ray diffraction, infrared molecular absorption spectroscopy, thermal analysis and atomic force microscopy. The characterization proved the interaction between LDH and 5ASA by changes in the interplanar distances and hydrogen interactions between drug and layer hydroxyls. This system presented a 25.5% of drug load. Also, the microscopy showed a rough surface in the system, indicating that the drug was not only present in the LDH interlayer space, but also adsorbed on its surface. This set of data indicate that the method was efficient for 5ASA intercalation in the LDH, reinforcing the proposal of LDHs as functional pharmaceutical excipients.

关键词： Noninvasive Ventilation   Pulmonary Rehabilitation   Intermittent Abdominal Pressure Ventilator   Ventilatory Pump Failure  

摘要： Noninvasive ventilation has become the initial treatment for symptomatic ventilatory pump failure but, when used at ventilatory support settings, can be an alternative to tracheostomy mechanical ventilation. The intermittent abdominal pressure ventilator, a corset with an internal air sack inflated by a ventilator, allows to increase tidal volumes through the raising of the diaphragm and its consequent passive descent. It has been used for daytime support for more than 70 yrs, but its knowledge among clinicians is scarce. A narrative review was performed by searching PubMed, Medline, and the Cochrane Database of Systematic Reviews using the terms "IAPV" or "pneumobelt." One hundred forty patients were cited using the intermittent abdominal pressure ventilator from 1946 until it went off the market in the 1970s, although many continued to use it. There was only one publication on its use from 2003 to 2017, but three publications from 2017 through 2021. It has been used for full diurnal ventilatory support by some patients for more than 50 yrs and has even been used throughout the labor of a mother with no ventilator-free breathing ability. The intermittent abdominal pressure ventilator is a ventilatory support alternative for patients with ventilatory pump failure. It can be effective and well tolerated and maintain quality of life without facial interfaces. More widespread application is warranted.

关键词： postprandial hyperglycemia   insulin resistance   insulin secretion   chrononutrition   dietary interventions   exercise  

摘要： As years progress, we are found more often in a postprandial than a postabsorptive state. Chrononutrition is an integral part of metabolism, pancreatic function, and hormone secretion. Eating most calories and carbohydrates at lunch time and early afternoon, avoiding late evening dinner, and keeping consistent number of daily meals and relative times of eating occasions seem to play a pivotal role for postprandial glycemia and insulin sensitivity. Sequence of meals and nutrients also play a significant role, as foods of low density such as vegetables, salads, or soups consumed first, followed by protein and then by starchy foods lead to ameliorated glycemic and insulin responses. There are several dietary schemes available, such as intermittent fasting regimes, which may improve glycemic and insulin responses. Weight loss is important for the treatment of insulin resistance, and it can be achieved by many approaches, such as low-fat, low-carbohydrate, Mediterranean-style diets, etc. Lifestyle interventions with small weight loss (7-10%), 150 min of weekly moderate intensity exercise and behavioral therapy approach can be highly effective in preventing and treating type 2 diabetes. Similarly, decreasing carbohydrates in meals also improves significantly glycemic and insulin responses, but the extent of this reduction should be individualized, patient-centered, and monitored. Alternative foods or ingredients, such as vinegar, yogurt, whey protein, peanuts and tree nuts should also be considered in ameliorating postprandial hyperglycemia and insulin resistance. This review aims to describe the available evidence about the effects of diet, chrononutrition, alternative dietary interventions and exercise on postprandial glycemia and insulin resistance.