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Alkaline, acid and acid-wet ball milling extraction of dietary fiber from kiwi berry (Actinidia arguta): Structural, rheological, physicochemical and functional properties
No full textDietary fiber (DF) has gained significant attention due to its potential health benefits, highlighting the need for optimized extraction techniques from various plant sources. In this study, the objective of the study was to evaluate the effects of several extraction techniques, such as alkaline (AL), acid (AC) and acid-wet ball milling (ACWB) on structural, rheological, physicochemical and functional characteristics of dietary fiber (DF) extracted from kiwi berry. The alkaline method involved using a NaOH solution, while the acid extraction utilized citric acid. The acid-wet ball milling method combined acid treatment with ball-milling to enhance fiber extraction. AL-DF had higher total dietary fiber and thermal stability than AC-DF and ACWB-DF. The Fourier transform infrared spectroscopy (FT-IR) spectra indicated peak intensity variation in three extracted DF fractions. The scanning electron microscopy (SEM) observation indicated that ACWB-DF exhibited a looser microstructure, and ACWB-DF had the smallest particle size (359.1 nm) as compared to those of AL-DF and AC-DF. In addition, ACWB-DF exhibited the lowest ζ-potential (−23.40 mV) and maximum viscosity (19.11 mPa s) among all samples. Furthermore, ACWB-DF has stronger water holding (3.91 g/g), oil holding (1.78 g/g), water swelling (6.47 mL/g), bile acid adsorption (387.75 mg/g), nitrite ion adsorption (720–785 μg/g) and glucose adsorption (193.41–374.87 mg/g) capacities than AL-DF and AC-DF fractions. Hence, ACWB-DF may have tremendous potential to be functional food additives in the food industry
Association of Knee Osteoarthritis Treatment Types, Patient Characteristics, and Medical History With Subsequent Risk for Total Knee Arthroplasty: Data From a New Real-World Registry
Get PDFBACKGROUND: This article examines predictors of subsequent total knee arthroplasty (TKA) within 6 months of nonoperative intervention based on (1) patient demographics; (2) knee osteoarthritis (OA) severity; and (3) various nonoperative treatments (cryoneurolysis with superficial or deep genicular nerve block, intra-articular [IA] hyaluronic acid injections, nonsteroidal inflammatory drug injections, IA-corticosteroids injections, or IA-triamcinolone extended-release [IA-TA-ER] injections). METHODS: Patients who had unilateral knee OA and received nonoperative intervention were identified in the Innovations in Genicular Outcomes Research registry between September 2021 and February 2024, identifying 505 patients. Baseline patient demographics were tabulated by knee OA severity as graded by Kellgren-Lawrence (KL) and nonoperative treatment, identifying patients who underwent TKA within 6 months. Predictors of TKA were identified using 20 potential demographic/clinical variables and calculating individual hazard ratios. RESULTS: Obesity and KL grade IV knees were significant predictors of TKA within 6 months of nonoperative treatment (P \u3c .05). Age, sex, marital status, number of comorbidities, physical activity level, smoking status, insurance type, and baseline pain and functional scores were not associated with subsequent TKA. Overall, treatment type was also not linked to subsequent TKA, although pairwise comparison suggested use of IA-TA-ER was associated with a decreased conversion to subsequent TKA (P = .002). CONCLUSIONS: Apart from obesity and KL grade IV knees, it remains challenging to identify which patients are at risk for conversion to subsequent TKA after nonoperative treatment. It appears IA hyaluronic acid and IA-TA-ER are most associated with decreased conversion to TKA within 6 months
Alcohol and cannabis use for pain management: Translational findings of relative risks, benefits, and interactions
Get PDFChronic pain affects over 20% of the global population and contributes to the vast burden of psychiatric illness. While effective treatments for chronic pain remain limited, both alcohol and cannabis have been used for centuries to manage pain and closely associated negative affective symptoms. However, persistent misuse of alcohol and/or cannabis in such a negative reinforcement fashion is hypothesized to increase the risk of severity of substance use disorders (SUDs). The current review describes neurobiological evidence for the analgesic efficacy of alcohol and primary cannabis constituents and how use or co-use of these substances may influence SUD risk
Longitudinal changes in positive airway pressure device use after metabolic surgery: a 3-year matched cohort study of National Claims Data
Get PDFBACKGROUND: Metabolic surgery (MS) is the most durable treatment of obesity and can treat obstructive sleep apnea (OSA). OBJECTIVES: To compare trajectories of positive airway pressure (PAP) device use between individuals who had MS and similar individuals who did not have MS (non-MS). SETTING: Merative MarketScan Research Databases - a US-based commercial claims database. METHODS: Those who underwent MS were matched 1:1 with nonoperative controls on baseline demographic and health characteristics. PAP use trajectories were examined in the 3years after the index dates and stratified by baseline PAP use. RESULTS: A total of 8772 adults who had MS were matched with 8772 adults who did not have MS; in both groups, 17.3% had baseline PAP claims. Among individuals who had baseline PAP claims, those who had MS had significantly higher rates of PAP use cessation (58.9% versus 27.1%; P value \u3c .01). Among individuals who were not using a PAP at baseline, PAP initiation was higher among those who did not have MS than those who had MS (10.8% versus 2.6%; P value \u3c .01). CONCLUSIONS: MS was associated with discontinuation of PAP use and decreased initiation of PAP use among individuals who were not using these devices, suggesting that MS leads to symptomatic and preventive treatment for OSA
Diabetes Mellitus and Associated Vascular Disease: Pathogenesis, Complications, and Evolving Treatments
Get PDFDiabetes mellitus is a metabolic disorder, characterized by elevated blood sugar levels (hyperglycemia) and insulin dysregulation. This disease is associated with morbidity and mortality, including significant potential vascular complications. High levels of hyperglycemia lead to not only elevated levels of reactive oxygen species but also advanced glycation end products, which are detrimental to the vascular endothelium and reduce protective compounds such as nitric oxide and prostacyclin. This damage contributes to the development of both macrovascular and microvascular complications. The present investigation explores the pathophysiological mechanisms of diabetic vascular complications and evaluates current management strategies, including lifestyle modifications, pharmacological treatments, and emerging therapies. The review underscores the importance of ongoing progress in diabetes management and patient education to lead to optimal patient-health outcomes and quality of life for individuals with diabetes mellitus
Periclavicular multifocal, infiltrative extraneural soft tissue perineuriomas: illustrative case
Get PDFBACKGROUND Perineuriomas are benign, typically solitary tumors with intraneural and extraneural subtypes presenting distinct clinical manifestations and symptomatology. Here, the authors report a unique case of multifocal, infiltrative extraneural soft tissue perineuriomas localized to the shoulder. OBSERVATIONS A 33-year-old female presented with 1 year of right neck and shoulder pain accompanied by a new onset of numbness and tingling down her right arm. MRI of a mass apparent over her right trapezius and scapula revealed several mixed cystic and solid neoplasms encroaching on the C5–6 nerve roots and brachial plexus. The tumors were biopsied and confirmed by immunohistochemical staining to be extraneural soft tissue perineuriomas. Further excision was carried out to relieve the patient of her symptoms associated with mass effect on the brachial plexus. LESSONS This case highlights the importance of a thorough workup of soft tissue and peripheral nerve sheath masses. There is extraordinary difficulty in diagnosing and treating extraneural perineuriomas, given their wide array of clinicopathological presentations, and it is crucial that these tumors are accurately identified to avoid overtreatment
Total Alimentary Limb Length Is Not Associated with Weight Loss Following Proximal Roux-en-Y Gastric Bypass
No full textBackground: Standard Roux-en-Y gastric bypass (RYGB) typically manipulates the proximal portion of the small intestine, leaving a variable and unknown common channel and total alimentary limb length (TALL). Despite high variability in postoperative weight loss, the factors contributing to this variability remain unknown. Given the known variability in small intestinal length, this unmeasured variability in TALL may be associated with weight loss responses. Objective: To test the hypothesis that TALL is associated with postoperative weight loss following primary laparoscopic Roux-en-Y gastric bypass (RYGB). Setting: Vanderbilt University Medical Center; Nashville, Tennessee, USA. Methods: A total of 329 patients were recruited for this observational study and consented to laparoscopic measurement of the entire small intestinal length at the time of primary RYGB. Of these patients, 208 had successful measurement of the small bowel length (SBL) and underwent RYGB with a fixed biliopancreatic limb length (BPL, 50 cm). Common channel length (CCL) was allowed to vary normally to test the association between TALL and postoperative weight loss. Results: Follow-up rates were 77% at 6 months and 41% at 24 months. Average SBL was 592 cm (min = 390 cm, max = 910 cm), with a standard deviation of 107 cm that led to significant variation in CCL (shortest 190 cm, longest 730 cm). Regression was used to model weight loss and body mass index, as well as percent change from baseline, for each patient given the measured TALL and CCL. Despite significant variation in TALL, there were no clinically significant effects of TALL or CCL on weight loss up to 24 months. Conclusions: With a fixed BPL, normal variation in TALL does not significantly contribute to weight loss variability following RYGB. Future studies are needed to better understand the importance of intestinal limb lengths in primary and revisional RYGB surgery
IMPACT OF A HOST-RESPONSE TEST IMPLEMENTATION ON SEPSIS MORTALITY IN PATIENTS PRESENTING TO THE ED
No full text54th Critical Care Congress of the Society of Critical Care Medicine, SCCM 2025, February 23 - 25, 2025, Orlando, F