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Plate waste study among hospitalised patients receiving texture-modified diet

  • Razalli, Nurul Huda;Cheah, Chui Fen;Mohammad, Nur Mahirah Amani;Manaf, Zahara Abdul
    • Nutrition Research and Practice
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    • v.15 no.5
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    • pp.655-671
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    • 2021
  • BACKGROUND/OBJECTIVES: While plate waste has been widely investigated in hospitals, there have been minimal studies specific to the texture-modified diet (TMD). This study aims to determine the percentage of plate waste among patients prescribed with TMD and its contributory factors. SUBJECTS/METHODS: This was a single-centre study conducted in the university hospital on three types of TMD (blended diet, mixed porridge, minced diet) during lunch and dinner meals. Weighing method and visual estimation method assisted by digital photograph were adopted in this study. Face to face interview was carried out to investigate on 1) the food/food service quality factors in terms of patients' satisfaction level towards sensorial quality of food and food services provided and 2) the clinical/external factors including appetite, the provision of oral nutrition support, time taking the diet, the need for feeding assistance and the length of hospital stay. RESULTS: The mean percentage of overall plate waste of 95 patients receiving TMD was high (47.5%). Blended diet was identified as the most wasted diet (65%) followed by minced diet (56%) and mixed porridge (35%). Satisfaction level among patients was moderate. Patients on TMD in general had higher satisfaction level on the aspect of food service as compared to food quality. Substantial association between sensorial qualities of food and plate waste were varied according to individual TMD type. A multiple linear regression showed that only the satisfaction level toward the aspects of appearance and variety of foods were the predictors of TMD plate waste (R2 = 0.254, P < 0.05). CONCLUSIONS: A significant relationship between the percentage of plate waste and the overall satisfaction level of patients receiving TMD suggests that vigorous strategies are needed to reduce the food waste of TMD which will lead to a better nutritional status and clinical outcomes among the patients.

Genotype-phenotype correlations in pediatric patients with myotonic dystrophy type 1

  • Kim, Hyeong Jung;Na, Ji-Hoon;Lee, Young-Mock
    • Clinical and Experimental Pediatrics
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    • v.62 no.2
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    • pp.55-61
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    • 2019
  • Purpose: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK ) gene. Our study aimed to determine whether the age of onset is correlated with CTG repeat length in a population of pediatric patients with DM1. Methods: We retrospectively identified 30 pediatric patients with DM1 that underwent DMPK testing, of which the clinical data of 17 was sufficient. The cohort was divided into 2 subgroups based on the clinical phenotype (congenital-onset vs. late-onset) and number of CTG repeats (<1,000 vs. ${\geq}1,000$). Results: We found no significant difference between the age of onset and CTG repeat length in our pediatric patient population. Based on clinical subgrouping, we found that the congenital-onset subgroup was statistically different with respect to several variables, including prematurity, rate of admission to neonatal intensive care unit, need for respiratory support at birth, hypotonia, dysphagia, ventilator dependence, and functional status on last visit, compared to the late-onset subgroup. Based on genetic subgrouping, we found a single variable (poor feeding in neonate) that was significantly different in the large CTG subgroup than that in the small CTG subgroup. Conclusion: Clinical variables exhibiting statistically significant differences between the subgroups should be focused on prognosis and designing tailored management approaches for the patients; our findings will contribute to achieve this important goal for treating patients with DM1.

The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study

  • El Koofy, Nehal Mohamed;Rady, Hanaa Ibrahim;Abdallah, Shrouk Moataz;Bazaraa, Hafez Mahmoud;Rabie, Walaa Ahmed;El-Ayadi, Ahmed Ali
    • Clinical and Experimental Pediatrics
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    • v.62 no.9
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    • pp.344-352
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    • 2019
  • Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. Purpose: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. Methods: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. Results: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. Conclusion: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

Identifying N sources that affect N uptake and assimilation in Vanda hybrid using 15N tracers

  • Panjama, Kanokwan;Ohyama, Takuji;Ohtake, Norikuni;Sato, Takashi;Potapohn, Nuttha;Sueyoshi, Kuni;Ruamrungsri, Soraya
    • Horticulture, Environment, and Biotechnology : HEB
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    • v.59 no.6
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    • pp.805-813
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    • 2018
  • Vanda is an aerial tropical orchid native to Thailand and nitrogen (N) fertilizer is mainly used to promote its growth and quality. However, little is known about the characteristics of N absorption and assimilation in Vanda. The objective of this study was to determine the appropriate source of N for Vanda cultivation. In this experiment, shoots and roots of Vanda 'Ratchaburi Fuchs-Katsura' were sprayed weekly with 100 ml of $^{15}N$ tracer solution (1) 10 mM of $^{15}NO_3{^-}$, (2) 5 mM of $^{15}NO_3{^-}$ plus 5 mM of $NH_4{^+}$, (3) 5 mM of $NO_3{^-}$ plus 5 mM of $^{15}NH_4{^+}$ and (4) 10 mM of $^{15}NH_4{^+}$. The results indicated that plants fed with a combined N fertilizer gave the highest of $^{15}N$ use efficiency ( $^{15}NUE$) of about 21.8%, 30 days after the first feeding (DAF), compared with those fed sole sources of $^{15}NO_3{^-}$ (21.0%) and $^{15}NH_4{^+}$ (16.6%). However, a sole nitrate fertilizer or combination fertilizer did not significantly affect the total N and labelled N content. Alanine was a major amino acid found in leaves and roots at 7 DAF, whereas glutamine was mainly found in stems. At 30 DAF, tyrosine and alanine became major components in the leaves, and glutamine decreased in stems when plants were fed with a single $^{15}NH_4{^+}$ source.

Frequency of anemia and micronutrient deficiency among children with cleft lip and palate: a single-center cross-sectional study from Uttarakhand, India

  • Chattopadhyay, Debarati;Vathulya, Madhubari;Naithani, Manisha;Jayaprakash, Praveen A;Palepu, Sarika;Bandyopadhyay, Arkapal;Kapoor, Akshay;Nath, Uttam Kumar
    • Archives of Craniofacial Surgery
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    • v.22 no.1
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    • pp.33-37
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    • 2021
  • Background: Children with cleft lip and/or palate can be undernourished due to feeding difficulties after birth. A vicious cycle ensues where malnutrition and low body weight precludes the child from having the corrective surgery, in the absence of which the child fails to gain weight. This study aimed to identify the proportion of malnutrition, including the deficiency of major micronutrients, namely iron, folate and vitamin B12, in children with cleft lip and/or palate and thus help in finding out what nutritional interventions can improve the scenario for these children. Methods: All children less than 5 years with cleft lip and/or cleft palate attending our institute were included. On their first visit, following were recorded: demographic data, assessment of malnutrition, investigations: complete blood count and peripheral blood film examination; serum albumin, ferritin, iron, folate, and vitamin B12 levels. Results: Eighty-one children with cleft lip and/or palate were included. Mean age was 25.37±21.49 months (range, 3-60 months). In 53% of children suffered from moderate to severe wasting, according to World Health Organization (WHO) classification. Iron deficiency state was found in 91.6% of children. In 35.80% of children had vitamin B12 deficiency and 23.45% had folate deficiency. No correlation was found between iron deficiency and the type of deformity. Conclusion: Iron deficiency state is almost universally present in children with cleft lip and palate. Thus, iron and folic acid supplementation should be given at first contact to improve iron reserve and hematological parameters for optimum and safe surgery.

Oral administration of Jinan Red Ginseng and licorice extract mixtures ameliorates nonalcoholic steatohepatitis by modulating lipogenesis

  • Yang, Daram;Jeong, Hyuneui;Hwang, Seung-Mi;Kim, Jong-Won;Moon, Hee-Won;Lee, Ye-Eun;Oh, Hyo-Bin;Park, Chung-berm;Kim, Bumseok
    • Journal of Ginseng Research
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    • v.46 no.1
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    • pp.126-137
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    • 2022
  • Background: Nonalcoholic steatohepatitis (NASH) is one of the main chronic liver diseases. NASH is identified by lipid accumulation, inflammation, and fibrosis. Jinan Red Ginseng (JRG) and licorice have been widely used because of their anti-inflammatory and hepatoprotective effects. Hence, this study assessed JRG and licorice extract mixtures' effects on NASH progression. Methods: Palmitic acid (PA) and the western diet (WD) plus, high glucose-fructose water were used to induce in vitro and in vivo NASH. Mice were orally administered with JRG-single (JRG-S) and JRG-mixtures (JRG-M; JRG-S + licorice) at 0, 50, 100, 200 or 400 mg/kg/day once a day during the last half-period of diet feeding. Results: JRG-S and JRG-M reduced NASH-related pathologies in WD-fed mice. JRG-S and JRG-M consistently decreased the mRNA level of genes related with inflammation, fibrosis, and lipid metabolism. The treatment of JRG-S and JRG-M also diminished the SREBP-1c protein levels and the p-AMPK/AMPK ratio. The FAS protein levels were decreased by JRG-M treatment both in vivo and in vitro but not JRG-S. Conclusion: JRG-M effectively reduced lipogenesis by modulating AMPK downstream signaling. Our findings suggest that this mixture can be used as a prophylactic or therapeutic alternative for the remedy of NASH.

Development of a High-Titer Culture Medium for the Production of Cholesterol by Engineered Saccharomyces cerevisiae and Its Fed-Batch Cultivation Strategy

  • Wang, Ling-Xu;Zheng, Gao-Fan;Xin, Xiu-Juan;An, Fa-Liang
    • Journal of Microbiology and Biotechnology
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    • v.32 no.9
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    • pp.1178-1185
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    • 2022
  • Steroids are a class of compounds with cyclopentane polyhydrophenanthrene as the parent nucleus, and they usually have unique biological and pharmacological activities. Most of the biosynthesis of steroids is completed by a series of enzymatic reactions starting from cholesterol. Synthetic biology can be used to synthesize cholesterol in engineered microorganisms, but the production of cholesterol is too low to further produce other high-value steroids from cholesterol as the raw material and precursor. In this work, combinational strategies were established to increase the production of cholesterol in engineered Saccharomyces cerevisiae RH6829. The basic medium for high cholesterol production was selected by screening 8 kinds of culture media. Single-factor optimization of the carbon and nitrogen sources of the culture medium, and the addition of calcium ions, zinc ions and citric acid, further increased the cholesterol production to 192.53 mg/l. In the 5-L bioreactor, through the establishment of strategies for glucose and citric acid feeding and dissolved oxygen regulation, the cholesterol production was further increased to 339.87 mg/l, which was 734% higher than that in the original medium. This is the highest titer of cholesterol produced by microorganisms currently reported. The fermentation program has also been conducted in a 50-L bioreactor to prove its stability and feasibility.

Effects of feed intake and water hardness on fluralaner pharmacokinetics in layer chickens

  • Sari, Ataman Bilge;Gunes, Yigit;Anlas, Ceren;Alkan, Fulya Ustun;Guncum, Enes;Ustuner, Oya;Bakirel, Tulay
    • Journal of Veterinary Science
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    • v.23 no.5
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    • pp.64.1-64.9
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    • 2022
  • Background: Fluralaner is a novel drug belonging to the isoxazoline class that acts on external parasites of domestic animals. It is used systemically via drinking water, especially against red poultry mite in layer chickens. Fluralaner is frequently used in layers infected with D. gallinae. However, no study to date has investigated the effects of feed intake and water hardness. Objectives: This study aimed to investigate the effects of variable water hardness and feed intake on the pharmacokinetic profile of fluralaner. Methods: Layer chickens were divided into four groups (n = 8): fed + purified water (Group 1), feed restricted + purified water (Group 2), feed restricted + hard water (Group 3), and feed restricted + soft water (Group 4). After administering a single dose of the drug with drinking water, the blood samples were collected for 21 days. Fluralaner concentrations in plasma samples were determined by liquid chromatography/tandem mass spectrometry. The maximum plasma concentration (Cmax), time to reach maximum plasma concentration (tmax), area under the concentration-time curve values (AUC0-21d), half-life (t1/2), and other pharmacokinetic parameters were calculated. Results: Although the highest maximum plasma concentration (Cmax) was determined in Group 1 (fed + purified water), no statistically significant difference was found in the Cmax, tmax, t1/2, MRT0-inf_obs, Vz/Fobs, and Cl/F_obs parameters between the experimental groups. Conclusions: It was concluded that the feed intake or water hardness did not change the pharmacokinetic profile of fluralaner in layer chickens. Therefore, fluralaner could be used before or after feeding with the varying water hardness in poultry industry.

Water film covering characteristic on horizontal fuel rod under impinging cooling condition

  • Penghui Zhang;Bowei Wang;Ronghua Chen;G.H. Su;Wenxi Tian;Suizheng Qiu
    • Nuclear Engineering and Technology
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    • v.54 no.11
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    • pp.4329-4337
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    • 2022
  • Jet impinging device is designed for decay heat removal on horizontal fuel rods in a low temperature heating reactor. An experimental system with a fuel rod simulator is established and experiments are performed to evaluate water film covering capacity, within 0.0287-0.0444 kg/ms mass flow rate, 0-164.1 kW/m2 heating flux and 13.8-91.4℃ feeding water temperature. An effective method to obtain the film coverage rate by infrared equipment is proposed. Water film flowing patterns are recoded and the film coverage rates at different circumference angles are measured. It is found the film coverage rate decreases with heating flux during single-phase convection, while increases after onset of nucleate boiling. Besides, film coverage rate is found affected by Marangoni effect and film accelerating effect, and surface wetting is significantly facilitated by bubble behavior. Based on the observed phenomenon and physical mechanism, dry-out depth and initial dry-out rate are proposed to evaluate film covering potential on a heating surface. A model to predict film coverage rate is proposed based on the data. The findings would have reliable guide and important implications for further evaluation and design of decay heat removal system of new reactors, and could be helpful for passive containment cooling research.

Combined Effects of Filter-feeding Bivalve and Zooplankton on the Growth Inhibition of Cyanobacterium Microcystis aeruginosa (남세균 제어를 위한 동물플랑크톤(Daphnia magna)과 패류(Unio douglasiae)의 단독 및 혼합적용)

  • Kim, Nan-Young;Park, Myung-Hwan;Hwang, Su-Ok;Kim, Baik-Ho;Hwang, Soon-Jin
    • Korean Journal of Ecology and Environment
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    • v.48 no.2
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    • pp.108-114
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    • 2015
  • Single - and combined effects of a domestic freshwater bivalve Unio douglasiae (7.6~8.6 cm in shell length) and zooplankton Daphnia magna (1~2 mm in body size) were examined to understand whether they inhibit the growth of harmful cyanobacterial bloom (i.e. Microcystis aeruginosa) in a eutrophic lake. The experiments were triplicated with twelve glass aquaria (40 L in volume); three aquaria without mussel and zooplankton, served as a control, three zooplankton aquaria (Z, density=40 indiv. $L^{-1}$), three mussel aquaria (M, density=0.5 indiv. $L^{-1}$), and three mussel plus zooplankton aquarium (ZM, density=40 indiv.Z $L^{-1}$ plus 0.5 indiv.M/L), respectively. Algal growth inhibition (%) calculated as a difference in the concentration of chlorophyll-a (Chl-a) before and after treatment. Chl-a in all aquaria decreased with the time, while a greatest algal inhibition was seen in the ZM aquaria. After 24 hrs of incubation, Chl-a concentration at the mid-depth (ca. 15 cm) in ZM aquaria reduced by 90.8% of the control, while 63.2% and 79.8% in Z and M aquaria, respectively. Interestingly, during the same period, the surface Chl-a was diminished by 51.9% and 65.4% relative to the control in Z and ZM aquaria, while 27.4% of initial concentration decreased in M aquarium, respectively. These results suggest that 1) this domestic freshwater filter-feeding bivalve plays a significant role in the control of cyanobacterial bloom (M. aeruginosa), and 2) the combination with zooplankton and mussel has a synergistic effect to diminish them, compared to the single treatment of zooplankton and mussel.