A comprehensive review on yogurt syneresis: effect of processing conditions and added additives.

Yogurt, produced by the lactic fermentation of milk base, is an important dairy product worldwide. One of the essential sensory properties of yogurt is the texture, and some textural defects such as weak gel firmness and syneresis likely occur in various types of yogurts, affecting consumer acceptance. In this regard, various strategies such as enrichment of milk-based with different additives and ingredients such as protein-based components (skimmed milk powder (SMP), whey protein-based powders (WP), casein-based powders (CP), and suitable stabilizers, as well as modification of processing conditions (homogenization, fermentation, and cooling), can be applied in order to reduce syneresis. The most effective proteins and stabilizers in syneresis reduction are CP and gelatin, respectively. Furthermore, yogurt's water holding capacity and syneresis can be affected by the type of starter cultures, the protolithic activity, production of extracellular polysaccharides, and inoculation rate. Moreover, optimizing the heat treatment process (85 °C/30 min and 95 °C/5 min), homogenization (single or dual-stage), incubation temperature (around 40 °C), and two-step cooling process can decrease yogurt syneresis. This review is aimed to investigate the effect of fortification of the milk base with various additives and optimization of process conditions on improving texture and preventing syneresis in yogurt.

Technological characteristics of sodium reduced wheat bread: Effects of fermentation type and partial replacement of salt with potassium chloride.

Rheological, physicochemical, textural, and sensory characteristics of wheat bread prepared by potassium chloride (KCl) substitution of sodium chloride (NaCl) at different ratio (0:100, 10:90, 20:80, 30:70, 40:60, 50:50) in the presence of two different fermentation types (Saccharomyces cerevisiae yeast starter (YSF) and mixed fermentation based on sourdough (MFSD)) were investigated. Considering the results obtained at this study, the technological characteristics change through KCl substitution ratio which depends on the type of fermentation. In other words, the enhanced activity of microflora in MFSD-fermented samples and decreased activity of yeast in YSF-fermented ones have been found by increasing the ratio of KCl incorporation level. Despite the increased activity of starter microflora in MFSD-fermented samples through increasing the KCl incorporation level, the lowest specific volume (p < .05) is found in SD50 (containing 50%w/w KCl in the presence of MFSD) with a quantity equal to 1.71 ± 0.47 cm3/g confirming its inability to restore gases. No significant difference has been found in KCl substitution levels up to 20%w/w in YSF-fermented samples (Y20) with control (p ≥ .05). The lowest crumb lightness (L*) (65.27 ± 0.12), highest cohesiveness (1.31 ± 0.07 mm), and springiness (0.76 ± 0.01) is also found in Y20. Considering sensory characteristics perception, no significant difference has been found in textural characteristics perception of Y10 and Y20 containing KCl at 10%w/w and 20% w/w, respectively, in the presence of YSF with control sample (Y). The overall acceptability is also found to be more influenced by texture perception(r = 0.827, p < .00).

Harmful compounds of soy milk: characterization and reduction strategies.

Soymilk is a plant based product which is a rich source of nutrients. However, various harmful compounds including allergens, anti-nutritional factors, and biogenic amines (BAs) exist in soybeans that may be transferred into soymilk. These compounds cause difficulties for consumers from mild to severe symptoms. Soymilk production is considered as a critical step in quantity of harmful compounds in final product. Common steps in soy milk manufacturing include soaking, grinding, and heating process. Allergens contents could be decreased by heating alone or in combination with structural modifiers and fermentation. BAs could be reduced by optimizing fermentation process and using suitable strains, especially BAs degradable types. Soaking, grinding and heating of soybeans in water are considered as effective methods for inactivation of antinutritional factors. Isoflavones are soy phytochemicals, which potentially leads to breast cancer in some women, can be converted to less bioavailable forms during processing. Other treatments such as high hydrostatic pressure and irradiation are also effective in harmful compounds reduction. Combination of the processes is more effective in harmful compounds removal. Considering the increasing trends in soymilk consumption, this review is focused on introduction of harmful compounds in soymilk and investigating the effects of processing condition on their concentration.

Risk Assessment of COVID-19 in the Iranian Health System.

OBJECTIVE: The outbreak of coronavirus disease 2019 (COVID-19) has exerted unprecedented pressure on healthcare systems throughout the world. This study was designed to develop a national health emergency management program based on risk assessment for COVID-19. METHODS: Mixed-methods research was used. Based on recommendations of the national epidemiology committee, 2 risk scenarios were used as basic scenarios for risk assessment. Two rounds of Focus Group Discussions (FGDs) were conducted between January and May 2020 with 30 representatives of the health system. The data were collected, analyzed, and integrated by the research team. RESULTS: In the risk matrix, "contamination of environment and individuals" and "burnout of medical staff" occupied the red zone (intolerable risk). "Defects in screening and admissions," "process disruption in medical care and rehabilitation," "increased mental disorders," "social dissatisfaction," "the decline in healthcare services," and "loss of medical staff" were identified as the orange zone (significant risk) of the matrix. CONCLUSIONS: The avoidance of environmental and individual contamination and healthcare worker burnout are the priorities in Iran. Attention to intersectoral cooperation, the involvement of non-governmental organizations and private center capacities, integration of information health systems, and developing evidence-based protocols are other measures that can improve the health system's capacity in the response COVID-19.

Risk Assessment of Arbaeen Mass Gathering in the Covid-19 Pandemic.

Introduction: Arbaeen is a religious ceremony held annually with the participation of a large number of pilgrims. During the pandemic of Covid-19, a mass gathering of Arbaeen pilgrims can strengthen the transmission of this disease and put more pressure on the health care system of countries. The aim of the study is to evaluate the risk of Arbaeen ceremony in the Covid-19 pandemic in 2021. Materials and methods: A mixed method was performed to perform the study using qualitative and quantitative methods. A national risk assessment tool was used that consisted of hazard identification and assessment, scenario development, exposure assessment, vulnerability assessment and risk estimation. The national risk assessment tool was completed through a focused group discussion and the opinions of 20 representatives of the health system and the level of risks were estimated. Data were collected, analyzed, and integrated by the research team. Results: Based on the results of risk matrix analysis, factors such as the increase in the number of new cases of COVID-19, the probability of exposure to a new variant of COVID-19, the probability of arrival of a new variant of COVID-19 to the country, the probability of increasing referrals to healthcare facilities (score 16), the probability of getting respiratory diseases, and the environmental contamination (score 12) occupied the red area of the matrix and were found to have the highest risk (unbearable risk), that needs immediate action. Conclusion: Preparing for a mass gathering such as Arbaeen is very important in order to reduce the risk of communicable disease, and the first step in improving preparedness is risk assessment and its continuity in the various stages of the ceremony. Therefore, policy makers and planners of such events should conduct risk assessments with the participation of local and national public health authorities regularly.

Challenges to manage pandemic of coronavirus disease (COVID-19) in Iran with a special situation: a qualitative multi-method study.

BACKGROUND: With the unprecedented expansion of COVID-19 in the world since December 2019, Iran's health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations. METHODS: The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously. RESULTS: Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community. CONCLUSIONS: According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions.

Acrylamide in bread: a review on formation, health risk assessment, and determination by analytical techniques.

Acrylamide is a water-soluble toxicant found in high-protein and carbohydrate-containing foods exposed to high temperature like bread as the staple foodstuff. This toxicant is mainly formed via Maillard reaction. The potential adverse effects of acrylamide especially possible carcinogenicity in human through dietary exposure necessitate its monitoring. Regarding the existence of its precursors in wheat bread formulation as well as extreme consumption of bread by most population and diversity of bread types, its acrylamide level needs to be investigated. The indicative value for acrylamide in wheat bread is set at 80 µg/kg. Consequently, its determination using liquid chromatography-tandem mass spectrometry (LC-MS/MS), gas chromatography-mass spectrometry (GC-MS), or capillary electrophoresis can be helpful considering both the risk assessment and quality control aspects. In this respect, methods based on LC-MS/MS show good recovery and within laboratory repeatability with a limit of detection of 3-20 µg/kg and limit of quantification of 10-50 µg/kg which is suitable for the immediate requirements for food product monitoring and calculation of consumer exposure.

Effective removal of lead (II) using chitosan and microbial adsorbents: Response surface methodology (RSM).

The ability of chitosan (1% w/v), Bifidobacterium longum (108 CFU mL-1) and Saccharomyces cerevisiae (108 CFU mL-1) separately or in combination (chitosan/B. longum, chitosan/S. cerevisiae, B. longum/S. cerevisiae) was assessed for lead (II) removal from aqueous solutions. The results showed chitosan/B. longum adsorbent had higher adsorption percentage in comparison with other adsorbents (p < 0.05). It was selected as the most efficient adsorbent and the effect of process variables including initial metal concentration (0.01-5 mg L-1), contact time (5-180 min), temperature (4-37 °C) and pH (3-6) on the its removal efficiency was evaluated with a Box-Behnken design. Twenty-seven test runs were performed and the optimal conditions for metal adsorption was observed at metal concentration of 2.5 mg L-1, contact time of 180 min, temperature of 37 °C and pH 4.5. The maximum lead (II) adsorption yield under optimal conditions was 97.6%. The foreign ions didn't diminish lead (II) adsorption by chitosan/B. longum and it had high selectivity toward the lead (II). Adsorption behavior was analyzed using the Freundlich and the Langmuir isotherms. The correlation coefficients (R2) demonstrated the Langmuir model had a better description on metal adsorption process. Overall, isotherms revealed chemisorption and physisorption were probably involved in metal adsorption on adsorbent.

Developing a Hospital Disaster Risk Management Evaluation Model.

PURPOSE: Disasters are increasing worldwide and hospitals should be prepared to respond well to such disasters. An effective hospital disaster risk management program saves peoples' lives, reduces damage to the hospital properties and assures hospital service continuity. This article aimed to develop and verify a Hospital Disaster Risk Management Evaluation model (HDRME). METHODS: A mixed-method explanatory sequential approach was used to develop and verify the HDRME model. The first draft of the HDRME model was introduced through a comprehensive literature review of major databases (i.e., PubMed, Scopus, Web of Science, and Science Direct), using appropriate keywords. Furthermore, 18 in-depth individual interviews were conducted with well-known experts in DRM to identify more HDRME constructs, sub-constructs, and standards. Then, three rounds of Delphi were conducted with 22 experts in hospital disaster risk management to verify the proposed model. RESULTS: The proposed HDRME consists of eight constructs, including seven enablers (management and leadership; risk assessment; planning; prevention and mitigation; preparedness; response, and recovery) and one result (key performance results). These constructs were further broken into 27 sub-constructs. The enablers and results scored 85% and 15% of the model's total scores. CONCLUSION: A comprehensive conceptual framework for the evaluation of hospital disaster risk management was introduced and verified. Standards and measurable elements can be embedded in this conceptual model to measure a hospital's preparedness in disasters and accordingly, corrective actions can be taken to strengthen the hospitals' responses to the disasters. However, the proposed model should be validated in a hospital setting through implementation.

Chitosan-Coated Alginate Microcapsules Loaded with Herbal galactagogue Extract: Formulation Optimization and Characterization.

Many herbs and spices have been recommended traditionally as galactagogues and several commercial formulations prepared using herbs. Due to the presence of various compounds such as polyphenols, flavonoids, isoflavones, and terpenes, bitter and stringent taste is elicited that make the consumption of these herbal preparations unpleasant. Moreover, these compounds are unstable when exposed to environmental conditions. In this regard, different approaches are used for taste masking such as microencapsulation. In the present study, microcapsules containing herbal galactagogue extract were developed through emulsification/external gelation and Box-Behnken design was used to investigate the effects of independent variables (sodium alginate: 1-1.5%, calcium chloride: 0.2-1% and extract concentrations: 1-5%) on encapsulation efficiency (EE%). Following evaluation of the model, the optimum condition of encapsulation process was selected as 1.49% sodium alginate, 0.84 CaCl2, and 1.58% extract with EE% of 77.97%. Microcapsules had an acceptable spherical morphology and the results of Fourier transform-infrared spectroscopy (FTIR) revealed the presence of the extract within the microcapsules. The mean diameters of the uncoated and chitosan-coated microcapsules were 52 and 123 µm and encapsulation yield was 50.21 and 69.7%, respectively. The polydispersity index of 0.45 and 0.48 were an indicative of polydisperse nature of the microcapsules. The loss of flavonoids in microcapsules stored at two different temperatures was insignificant. The in-vitro release in simulated gastric fluid (SGF; pH 1.2) and simulated intestinal fluid (SIF; pH 7.4) were 48.1% and 80.11%, respectively during 24 h. The prepared extract-loaded microcapsules have potential to be used in matrices with neutral pH.

Microencapsulation of microbial canthaxanthin with alginate and high methoxyl pectin and evaluation the release properties in neutral and acidic condition.

Canthaxanthin (CX) is an orange-red keto-carotenoid with high antioxidant activity. This functional pigment is sensitive to oxygen, light, pH and heat. In this study, CX was produced by the Dietzia natronolimnaea HS-1 and was encapsulated in Alginate (Alg) and Alg-high methoxyl pectin (HMP) through O/W/O multiple emulsion/external gelation method to developed resistant microparticles among acidic and neutral pHs. Results showed that initial CX concentration had a significant influence on total CX (TCX), surface CX (SCX), microencapsulation efficiency (EE) and particles size. The highest EE% for Alg (60.21 ±â€¯0.18) and Alg-HMP (70.60 ±â€¯0.68) were obtained with CX initial concentration of 11 and 18 µg/mg, respectively. Alg microparticles showed smaller size compare to Alg-HMP microcapsules. Presence of CX in microparticles and good antioxidant activity was confirmed by FT-IR spectroscopy and DPPH assay, respectively. CX in vitro release was 66% and 49% in acidic condition and 76% and 50% in neutral condition for Alg and Alg-HMP, respectively. Thus, Alg-HMP-CX18 microparticles were selected to be used in both neutral and acidic foods such as milk and fermented milks products as an antioxidant and a colorant agent.