Skovsherman8520

The surfactants used for emulsion is one of the best techniques for microencapsulation of lactic acid bacteria (LAB) since it is economical. The biosurfactants have many advantages such as lower toxicity, higher biodegradability. In this study, microcapsules were prepared via spray drying using Bifidobacterium adolescentis species cultured in soy milk extract with biosurfactant prepared using Alcaligenes piechaudii CC-ESB2 to improve their powder properties. The soy milk was used to increase the health benefits instead of the milk. The optimum bacterial strain viability, water activity, and moisture content of the microcapsules were achieved at a spray dryer inlet/outlet temperature of 120/60°C. The composition of the carrier affects the particle size of the microcapsules. Using 90% maltodextrin (MD), 5% isomalto-oligosaccharide syrup (IMOS) and 5% biosurfactant as a carrier increased the viability of the LAB. Scanning electron microscope observations showed that the LAB microcapsules were able to effectively retain their completeness. Furthermore, microcapsules added with a biosurfactant prepared using A. piechaudii CC-ESB2 displayed significantly better flow properties than those without the surfactant and biosurfactant, which indicates that the biosurfactant assists in enhancing the powder properties of the microcapsules. It also has sufficient biological activity as a LAB product because the probiotics exceed 106 CFU/mL The spray-dried abandoned supernatant with biosurfactant exhibited superior bacteriostasis, which suggests that the supernatant of B. adolescentis during microencapsulation not only retains its bacteriostatic effect under high spray drying temperatures, but also provides additional antibacterial effects for the microcapsules.

Transarterial radioembolization (TARE) with yttrium-90 (

Y) glass microspheres is an efficacious option for converting appropriately selected patients with borderline-resectable hepatocellular carcinoma (HCC) to surgical candidacy.

In 2018 and 2019, a diverse multidisciplinary group of surgical and interventional experts with experience using

Y for downstaging and bridging to liver transplant convened to review peer-reviewed literature and personal experience in the use of

Y to convert borderline resectable liver cancer patients to surgical candidacy. The working group included surgical oncologists specializing in liver cancer, liver transplant surgeons with experience in complex hepatobiliary surgery, and interventional radiologists with experience using

Y.

This document presents expert recommendations based upon the group's experience and consensus.

By combining related evidence from the literature with expert experiences with TARE in surgical candidates, these recommendations aim to demonstrate the safety, efficacy, and feasibility of TARE in converting borderline-resectable patients to surgical options. The document also addresses the concerns about potential complications associated with TARE during the surgical intervention.

By combining related evidence from the literature with expert experiences with TARE in surgical candidates, these recommendations aim to demonstrate the safety, efficacy, and feasibility of TARE in converting borderline-resectable patients to surgical options. The document also addresses the concerns about potential complications associated with TARE during the surgical intervention.

Multimodal analgesia and regional anesthetic blocks, such as transversus abdominis plane (TAP) block, decrease postoperative opiate consumption but their effect on intraoperative opiates is unknown.

This was a retrospective review of patients undergoing pancreatoduodenectomy between June 2018 and February 2021, in which perioperative data, operative times, and medication administration data were collected. Intraoperative opiate use was calculated in total morphine equivalent doses (MED) for each patient and adjusted for operative time. Univariate analysis and multivariate linear regression were performed to determine factors affecting intraoperative opiate requirements.

Of the 169 patients in the study, 51 (30.2%) received pre-surgical TAP blocks and 118 (69.8%) did not. There were no statistically significant differences in intraoperative opiate use with preoperative acetaminophen (p=0.527), celecoxib (p=0.553), gabapentin (p=0.308), intraoperative ketorolac (p=0.698) or epidural placement (p=0.086). Minimally invasive surgery had lower intraoperative opiate use compared to open (p=0.011), as well as pre-surgical TAP block compared to no pre-surgical block (5.24 vs 7.27 MED/hour, p<0.001). On multivariate linear regression, pre-surgical TAP block (p=0.001) was independently associated with decreased intraoperative opiate use.

Preoperative TAP blocks were associated with decreased intraoperative opiate use during pancreatoduodenectomy and should be considered for routine use.

Preoperative TAP blocks were associated with decreased intraoperative opiate use during pancreatoduodenectomy and should be considered for routine use.

Prostate cancer (PCA) germline testing (GT) is now standard-of-care for men with advanced PCA. Thousands of men may consider GT due to clinical and family history (FH) features. Identifying and consenting men for GT can be complex. Here we identified barriers and facilitators of GT across a spectrum of providers which informed the development of Helix - an educational and clinical/FH collection tool to facilitate GT in practice.

A 12-question survey assessing knowledge of genetics PCA risk and FH was administered December 2017 to March 2018 in the Philadelphia area and at the Mid-Atlantic AUA meeting (March 2018). Responses were analyzed using descriptive statistics. Deutivacaftor cost Semi-structured interviews were conducted with medical oncologists, radiation oncologists, and urologists across practice settings from March-October 2020 as part of a larger study based on the Tailored Implementation in Chronic Diseases framework. Helix was then developed followed by user testing.

Fifty-six providers (50% urologists) responded to the survey. Multiple FH and genetic knowledge gaps were identified only 66% collected maternal FH and 43% correctly identified BRCA2 and association to aggressive PCA. Genetic counseling gaps included low rates of discussing genetic discrimination laws (45%). Provider interviews (n = 14) identified barriers to FH intake including access to details and time needed. In user testing (n = 10), providers found Helix helpful for FH collection. All providers found Helix easy to use, suggesting expanded clinical use.

Helix addressed multiple GT knowledge and practice gaps across a spectrum of providers. This tool will become publicly available soon to facilitate PCA GT in clinical practice.

Helix addressed multiple GT knowledge and practice gaps across a spectrum of providers. This tool will become publicly available soon to facilitate PCA GT in clinical practice.The sterol-sensing domain (SSD) is present in several membrane proteins that function in cholesterol metabolism, transport, and signaling. Recent progress in structural studies of SSD-containing proteins, such as sterol regulatory element-binding protein (SREBP)-cleavage activating protein (Scap), Patched, Niemann-Pick disease type C1 (NPC1), and related proteins, reveals a conserved core that is essential for their sterol-dependent functions. This domain, by its name, 'senses' the presence of sterol substrates through interactions and may modulate protein behaviors with changing sterol levels. We summarize recent advances in structural and mechanistic investigations of these proteins and propose to divide them to two classes M for 'moderator' proteins that regulate sterol metabolism in response to membrane sterol levels, and T for 'transporter' proteins that harbor inner tunnels for cargo trafficking across cellular membranes.

This study aims to develop the Perioperative Privacy Scale and test its validity and reliability.

This is a methodological study.

This study was conducted with 298 patients who were hospitalized in surgical clinics in a university hospital, met the inclusion criteria, and agreed to participate in the study. The data were collected using a personal information form and the Perioperative Privacy Scale developed by the researchers. This methodological study was conducted between August 2019 and March 2020. The items of the scale were determined after a literature review and qualitative interviews with the patients.The draft version created to test the scale's content and face validity was reviewed by 11 experts (faculty members). Six items were omitted from the 37-item pool and revisions were made based on the experts' opinions and recommendations. Data analysis was conducted using the content validity index specially for content validity, and exploratory and confirmatory factor analyses for construct valial clinics regarding privacy.

The aim of this study is to determine the effectiveness of forced-air warming blankets in normalizing body temperature in the postoperative period.

Randomized controlled trial METHODS The study sample consisted of patients (N=67) who underwent lung lobectomy in the Thoracic Surgery Service of a university hospital. Forced-air warming blankets were used in the treatment group and 100% cotton blankets were used in the control group. Patients' body temperatures were monitored using a tympanic thermometer until it reached 37°C.

The body temperature of the patients in the treatment group reached 37°C in a shorter time than that of the patients in the control group (52.27 ± 29.79 min and 139.0 ± 81.93 min, respectively; P < .001), and that the perception of comfort of the patients in the treatment and control groups increased (P < .001) after warming.

We recommend that forced-air warming blankets are used for patients undergoing lung lobectomy in order to reach normal body temperature in a shorter time.

We recommend that forced-air warming blankets are used for patients undergoing lung lobectomy in order to reach normal body temperature in a shorter time.

Children with cerebral palsy are highly likely to develop foot deformities, some of which may require surgical intervention. Hallux valgus is a common forefoot deformity which can cause issues with pain, footwear, orthotic splints and soft tissues. It remains unclear what the optimal surgical treatment is for children with cerebral palsy and hallux valgus deformity.

To systematically review studies reporting the clinical and radiological outcomes of surgical correction of hallux valgus deformity in children with cerebral palsy.

A systematic review of studies published in electronic databases (Medline, Embase, Pubmed and Cochrane library) from inception until January 2021. Keywords related to hallux valgus and cerebral palsy were included.

58 studies were identified of which 7 met the criteria for inclusion. 200 feet in 134 patients with a mean age of 13.5 years were included, with a mean follow up period of 43 months. A range of clinical and radiographic outcomes were assessed. A treatment framework for the assessment and management of hallux valgus in children with cerebral palsy based on the published evidence is presented.

Non-ambulant children with cerebral palsy with symptomatic hallux valgus should primarily undergo first MTPJ arthrodesis whilst those who are ambulant should undergo first metatarsal osteotomy±soft tissue correction.

Non-ambulant children with cerebral palsy with symptomatic hallux valgus should primarily undergo first MTPJ arthrodesis whilst those who are ambulant should undergo first metatarsal osteotomy± soft tissue correction.