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Background: Brewer Ìs spent grain (BSG) is a biomass by-product generated in large volumes during industrial beer production. BSG has become a growing environmental problem, as most breweries discard it inappropriately, negatively impacting the environment. Alternatives for the exploitation of this by-product have consisted of elaborating food supplements for farm animals, obtaining biofuels, developing adsorbents, and obtaining substances for the food industry. However, the high moisture content in BSG (approximately 70%), poses a significant challenge in exploring various reuse alternatives. Therefore, the implementation of a pre-drying process becomes essential. Objective: This study aimed to analyze the BSG drying kinetics at different temperatures and the effect of the drying temperature on the physical properties and the content of bioactive compounds. Methods: BSG samples were dried at different temperatures (50, 60, 70, 80, 90, and 105°C) and analyzed for their moisture ratio, water activity, total polyphenol content (TPC), and DPPH (1,1-diphenyl-2-picrylhydrazil) radical scavenging activity. Also, four kinetics models were fitted to the drying data. Results:It was determined that the effective diffusivity was between 5.23x10
Antecedentes: El Bagazo residual de malta (BSG por sus siglas en inglés) es un subproducto biomásico generado en grandes volúmenes durante la producción industrial de cerveza. El BSG se ha convertido en un creciente problema para el medio ambiente, debido a que la mayoría de las cervecerías descartan inapropiadamente este residuo generando un impacto negativo al ambiente. Las alternativas para el aprovechamiento de este subproducto han consistido especialmente en la elaboración de suplementos alimenticios para animales de granja, obtención de biocombustibles, desarrollo de adsorbentes y obtención de productos para la industria alimentaria. Sin embargo, el alto contenido de humedad (~70%) del BSG representa un reto para el desarrollo de diferentes alternativas de reutilización, por lo que se hace necesario un proceso de secado previo. Objetivos: En este estudio se analizó la cinética de secado del BSG a diferentes temperaturas y el efecto de la temperatura de secado sobre sus propiedades físicas y contenido de compuestos bioactivos. Métodos: Las muestras de BSG fueron secadas a diferentes temperaturas (50, 60, 70, 80, 90 y 105°C) y analizadas en términos de razón de humedad, actividad acuosa, contenido de polifenoles totales (TPC) y actividad secuestradora del radical DPPH. Además, se ajustaron 4 modelos cinéticos a los datos de secado. Resultados: Se determinó que la difusividad efectiva del BSG varió entre 5.23x10
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Humans , Malta , Temperature , Beer , Kinetics , BiomassABSTRACT
Introducción: La babesiosis es una enfermedad causada por protozoos intraeritrocíticos con características clínicas que son similares a las de la malaria, se transmite a los seres humanos a través de la picadura de una garrapata infectada, ocasionalmente por transfusión. A nivel global la prevalencia de la enfermedad es desestimada; se desconoce esa proporción en Latinoamérica y Venezuela. Caso clínico: Paciente masculino de 29 años con fiebre de 15 días, ictericia, dolor abdominal, en quien se sospechó malaria por epidemiología y síntomas, se descartaron otras entidades como endocarditis, leptospirosis, tuvo serología positiva para ehrlichiosis, sin embargo, persistió clínica a pesar del tratamiento con cloroquina, clindamicina y doxiciclina; por tanto, se realizaron estudios complementarios con hallazgo de inclusiones intraeritrocíticas compatibles con babesiosis e inició terapia con clindamicina y quinina por 7 días con evolución satisfactoria. Discusión: El caso reportado requirió de un ejercicio clínico y apoyo interdisciplinario para un desenlace adecuado. Entre los diagnósticos diferenciales de enfermedades intraeritrocitarias se encuentra la babesiosis cuyos síntomas son inespecíficos, pero orienta su diagnóstico al indagar en el antecedente epidemiológico. El tratamiento incluye Atovacuona con Azitromicina o alternativas como Clindamicina con Quinina. Conclusiones: El presente caso fue bastante complejo dado su forma de presentación y al ser una enfermedad con una baja prevalencia en nuestro país, sin embargo, predominó el juicio clínico logrando el mejor resultado posible.
Introduction: Babesiosis is a disease caused by intraerythrocyte protozoa with clinical characteristics that are similar to those of malaria, it is transmitted to humans through the bite of an infected tick, occasionally by transfusion. Globally, the prevalence of the disease is underestimated; this proportion is unknown in Latin America and Venezuela. Clinical case: A 29-year-old male patient with a 15-day fever, jaundice, abdominal pain, in whom malaria was suspected based on epidemiology and symptoms, other entities such as endocarditis, leptospirosis were ruled out, he had positive serology for ehrlichiosis, however, it clinical symptoms persisted despite treatment with chloroquine, clindamycin and doxycycline; therefore, complementary studies were conducted with findings of intraerythrocyte inclusions compatible with Babesiosis and started treatment with clindamycin and quinine for 7 days and presented satisfactory evolution. Discussion: The reported case required a clinical exercise and interdisciplinary support for an adequate outcome. Among the differential diagnoses of intraerythrocyte diseases is babesiosis whose symptoms are non-specific, but guides its diagnosis by inquiring into the epidemiological history. Treatment includes atovaquone with azithromycin or alternatives such as clindamycin with quinine. Conclusions: The present case was quite complex given its form of presentation and being a disease with a low prevalence in our country, however, clinical judgment predominated, achieving the best possible result.
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Resumen Introducción: La fiebre de malta (brucelosis) es una infección zoonótica producida por cocobacilos gramnegativos, intracelulares facultativos, los cuales se transmiten por el consumo de productos animales no pasteurizados infectados, el contacto de la piel o las membranas mucosas con tejido animal infectado, fluidos animales infectados e inhalación de partículas aerosolizadas infectadas. Caso: Hombre de 34 años residente en zona rural, quien se dedicaba a la ganadería, ingreso a urgencias por presentar cuadro clínico de 15 días de evolución consistente en picos febriles no cuantificados asociados a escalofríos, astenia, adinamia y mialgias. Mediante la correlación clínico-patológica se llegó al diagnóstico de infección por Brucella Abortus. Conclusión : Esta patología es más frecuente en varones adultos. Dentro del cuadro clínico, Los estudios de serológicos (anticuerpos, aglutinación y ensayo inmunocromatográfico) tienen la mayor sensibilidad y especificidad diagnostica. El tratamiento se da con medicamentos que actúen en entornos intracelulares ácidos (tetraciclinas, aminoglucosidos, fluoroquinolonas), esto con el fin de controlar la enfermedad, prevenir las complicaciones y evitar las recaídas.
Abstract Introduction: Malta fever (brucellosis) is a zoonotic infection produced by intracellular gram-negative coccobacilli, which is transmitted by the consumption of infected unpasteurized animal products, skin contact or mucous membranes with infected animal tissues and fluids, and inhalation of infected aerosolized particles. Case: A 34-year-old man living in a rural area, who works in livestock, was admitted to the emergency department for presenting a clinical picture of 15 days of evolution of unquantified febrile peaks associated with symptoms such as chills, asthenia, adynamia and myalgia. The diagnosis of infection with Brucella Abortus was given through clinical-pathological correlation. Conclusion: This pathology is more frequent in adult males. Serological studies (antibodies, agglutination and immunochromatographic assay) prove to have the highest sensitivity and diagnostic specificity in the clinical picture. The treatment is given with medication that acts on intracellular acidic environment (tetracyclines, aminoglycosides, fluoroquinolones), this in order to control the disease, and prevent complications and relapses.
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Objective: To determine the temporal patterns of cumulative incidence of brucellosis using autoregressive integrated moving average models. Methods: This cross-sectional study employed yearly and monthly data of 1 117 laboratory-confirmed human brucellosis cases from January 2013 to December 2018 using the Yazd brucellosis national surveillance system. The monthly incidences constructed a timeseries model. The trend of cumulative incidence was perceived by tracing a line plot, which displayed a seasonal trend with periodicity. Thus, the ARIMA models were selected. Thereafter, Akaike information criteria (AIC) and Bayesian information criterion (BIC) values among different models indicated a preferable model from models which were expanded by diverse lags [(3, 0, 3), (2, 0, 3), (3, 0, 2), (4, 0, 3) and (3, 0, 4)]. Then, the achieved ARIMA model was applied to the forecasting cumulative incidence of monthly brucellosis incidences. All analyses were performed using Stata, version 11.2. Results: For the ARIMA (3, 0, 4) model, MAPE value was 56.20% with standard error 0.009-0.016, and white noise diagnostic check (Q=19.79, P=0.975) for the residuals of the selected model showed that the data were completely modelled. The monthly incidences that were fitted by the ARIMA (3, 0, 4) model, with AIC (25.7) and BIC (43.35) with a similar pattern of actual cases from 2013 to 2018 and forecasting incidences from January 2019 to December 2019 were, respectively, 0.50, 0.44, 0.45, 0.49, 0.55, 0.58, 0.56, 0.51, 0.46, 0.44, 0.45 and 0.49 per 100 000 people. Conclusions: In summary, the study showed that the ARIMA (3, 0, 4) model can be applied to forecast human brucellosis patterns in Yazd province, supplementing present surveillance systems, and may be better for health policy-makers and planners.
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Objective: To determine the temporal patterns of cumulative incidence of brucellosis using autoregressive integrated moving average models. Methods: This cross-sectional study employed yearly and monthly data of 1 117 laboratory-confirmed human brucellosis cases from January 2013 to December 2018 using the Yazd brucellosis national surveillance system. The monthly incidences constructed a timeseries model. The trend of cumulative incidence was perceived by tracing a line plot, which displayed a seasonal trend with periodicity. Thus, the ARIMA models were selected. Thereafter, Akaike information criteria (AIC) and Bayesian information criterion (BIC) values among different models indicated a preferable model from models which were expanded by diverse lags [(3, 0, 3), (2, 0, 3), (3, 0, 2), (4, 0, 3) and (3, 0, 4)]. Then, the achieved ARIMA model was applied to the forecasting cumulative incidence of monthly brucellosis incidences. All analyses were performed using Stata, version 11.2. Results: For the ARIMA (3, 0, 4) model, MAPE value was 56.20% with standard error 0.009-0.016, and white noise diagnostic check (Q=19.79, P=0.975) for the residuals of the selected model showed that the data were completely modelled. The monthly incidences that were fitted by the ARIMA (3, 0, 4) model, with AIC (25.7) and BIC (43.35) with a similar pattern of actual cases from 2013 to 2018 and forecasting incidences from January 2019 to December 2019 were, respectively, 0.50, 0.44, 0.45, 0.49, 0.55, 0.58, 0.56, 0.51, 0.46, 0.44, 0.45 and 0.49 per 100 000 people. Conclusions: In summary, the study showed that the ARIMA (3, 0, 4) model can be applied to forecast human brucellosis patterns in Yazd province, supplementing present surveillance systems, and may be better for health policy-makers and planners.
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Brucellosis is an old, infectious and common zoonosis whose causative agents are Gramnegative bacteria from the Brucella genus. Brucellosis is transmitted through direct contact with infected animals or using unpasteurized dairy products of goats, pigs, camels, sheep, buffalo and cows. Brucellosis is still the most common zoonosis in the world, with most of cases occurring in developing countries. Today, an approach to traditional medicine and medicinal plants, especially with regards to the repeated recommendations of the World Health Organization, is a necessity. One-third of chemical drugs are produced by using plants and there is a high potential to produce more drugs from plants. Medicinal plants are helpful in the management of various conditions, especially bacterial diseases. Although there is not enough scientific evidence regarding the clinical effectiveness of herbal drugs for the treatment of brucellosis, there is strong evidence on the antimicrobial effects of herbal drugs to prevent infection. Therefore, this article seeks to describe the antibacterial effects of some plant-derived essential oils or extracts, so that they can serve as promising choices to develop new anti-Brucella medications, as suitable alternatives to conventional antibiotics for brucellosis, as much as possible, taking into account the benefits of these herbal drugs.
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It was the honor to participate in the exchange program between University of Malta and Soochow University focusing on Dementia care;gerontology and elderly rehabilitation care from September 2016 to January 2017. During those 5 months, as a nursing graduate student, the experience which made me a deeply impression is the point of view ofperson-centred carefrom the medical care I′ve seen in Malta. This essay combined with the exchange experience through clinical observation and practice at hospitals in Malta, is going to highlight the point of view of person-centred care. That can reflect on some shortages of domestic in the medical care environment in China, hoping for a morehumane, moreperson-centred, andperson in heartmedical care environment.
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Introduction: The ratio of male to female live birth is defined as male births divided by total births (M/T) and is expected to approximate 0.515. This study was carried out in order to ascertain whether M/T in Malta was in any way influenced by the World Cup. Methods: Index months were months in which the World Cup was held (always in June), from 1958 to 2010 (n=14). Live births were analysed for January before the event to nine months after (the following March). Results: This study analysed 297254 live births. The decline from June to February was highly significant (p=0.001). A dip in M/T was noted in the February after the World Cup and this significantly lower when compared to the previous January to January period (p=0.001). M/T in these Februaries was also significantly lower than that in the other Februaries in the rest of the period studied (p=0.0023). Discussion: The majority of fans side with Italian or English national teams for old colonial political reasons. Stress leading up to and following the World Cup may have reduced M/T in Malta, with a rapid recovery when the effect passed.
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Aims: In humans, male births occur in excess of female births. The ratio of male births to total births (MFR) is expected to approximate 0.515. Many factors have been shown to influence MRF and a seasonal pattern has also been described. This study was carried out in order to ascertain whether seasonal variation in MRF exists in Maltese live births and whether environmental influences exert any role. Methods: Monthly live births subdivided by gender, were obtained from official Maltese government publications for the period 1958-2013. Analysis was carried out with SPSS, the Bio- Med-Stat Excel add-in for contingency tables and Demetra, using chi square tests, ANOVA, Freidman and Kruskall-Wallis tests, correlation, regression, and ARIMA models. Mean annual temperatures were available to 1958. Monthly data for maximum and minimum monthly temperatures, relative mean humidity, lowest relative humidity, hours of bright sunshine and rainfall was only available for 2001 to 2012. Results: This study analysed 297254 live births (153652 males and 143602 females, MRF 0.5169, 95% CI 0.5151-0.5187). MRF exhibited a non-significant bimodal pattern (June and December peak). MRF displayed a significant negative correlation between MRF and average mean yearly temperature (p=0.049). There was an association between monthly mean relative humidity and MRF (p = 0.03). Discussion: The nonsignificant seasonal pattern seen accords with that previously documented for other countries but the negative MRF correlation with mean annual temperature goes contrary to that previously documented in other countries. The humidity association has not been previously described. Conclusion: Some seasonal variation may exist in MFR in Malta.
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Aim: The male to female ratio at birth declines with stress. In Malta, parliamentary elections are highly divisive and stressful. This paper looked at the association of M/F with parliamentary elections and other important political events in Malta. Methodology: A retrospective analysis of monthly male and female births was carried out. These were obtained from official Malta Government publications back to 1966. Index months were months in which parliamentary elections were held. Eleven elections were included which comprised all those wherein elections were essentially contested by two parties between 1966-2013. The monthly sums for live births for each gender were summated for the months prior and following each election and for four other political but non-electoral events. Analysis was carried out with chi tests and chi tests for trend. Results: This study analysed a total of 168795 live births. For the period 1966-2013, mean M/F was 0.5176 (95% CI 0.5156-0.5196). For elections, a peak in M/F was found at month -7, followed by a decline down to the election month, and this decline was statistically significant (p=0.005). The ensuing return to the baseline over the next few months did not reach statistical significance. The converse was noted in non-electoral events, with an increasing trend in M/F from month -10 to month -1 (p=0.003). This was followed by a significant decline from month-1 to month +4 (p=0.002). Conclusions: In Malta, since the early 1970s, the country has developed one of the purest two-party systems in existence, a structure that has produced intense political polarization of most of the Maltese society. It possible that stress leading up to elections suffices to depress M/F in Malta. The converse occurred in relation to non-electoral events. To the author’s knowledge, this is the first reported instance wherein local elections and other political events influence M/F.
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Las opiniones bioéticas vertidas en torno a la huelga de hambre de los estudiantes exacerban el conflicto y desenfocan la reflexión al proclamar la inmadurez de los actores y poner en duda la legitimidad ética de poner la vida en riesgo por una causa o un ideal. La bioética aporta poco si solo plantea interrogantes de sentido común en vez de presentar argumentos para enriquecer y agilizar la deliberación, y debatir sobre las influencias externas que desencadenan una decisión privada pero de manifestación pública y alcances políticos. La Declaración de Malta reconoce el trágico dilema ético-médico entre el respeto por la autonomía de los pacientes o protegidos por el médico, frente al igualmente poderoso deber de respetar la vida e impedir una muerte evitable. El dilema entre dignidad y vida es trágico porque, no pudiendo ser leal a ambos deberes, la elección necesariamente implica consecuencias nefastas y eventualmente letales. Si bien la decisión de huelga es personal, se trata de una manifestación dirigida a la sociedad, de manera que las decisiones y actitudes reactivas de médicos, autoridades, dirigentes sociales serán, quiérase o no, un manifiesto político y deben ser vistas desde la ética de responsabilidad. La bioética ha de cultivar la prudencia, desaconsejando caer en decisiones incorregibles y de consecuencias irreversibles. Es imperioso evitar situaciones trágicas que no pueden resolverse sin altos costos y daños coerción, deterioro físico, muerte, propiciando que los movimientos políticos desaconsejen de inicio el uso de la huelga de hambre como medio de presión, por cuanto cualquier desenlace será en mayor o menor grado maleficente.
The students hunger strike has been inappropriately focused by opinions expressed and published mainly by local bioethicists and other academicians, when arguing that the strikers are immature, and that hunger strikes are ethically illegitimate. Although initiating a hunger strike is a private and personal matter, it is a public expression aiming at political effects. Therefore, influence and interventions by external agents physicians, authorities, social leaders have strong political connotations and carry responsibilities that require ethical analysis. Since the outcome of a hunger strike inevitably causes harm and mal eficence coercion, physical decay, death, bioethics should strongly advocate that political movements ought to dissuade their supporters from employing the hunger strike as a political pressure tool, for whichever way such a strike finally ends, it will have led to incorrigible decisions and irreversible negative consequences. The Declaration of Malta pinpoints the dilemma between respecting the strikers autonomy and fulfilling the medical duty of avoiding evitable death. This dilemma between dignity and life is the scenario of tragic decisions, where any alternative chosen will have dire consequences and political effects. For this reason, bioethics is called on to exercise and advice prudence.