Effectiveness of antioxidants in preventing oxidation of palm oil enriched with heme iron: A model for iron fortification in baked products

Bakery products such as biscuits, cookies, and pastries represent a good medium for iron fortification in food products, since they are consumed by a large proportion of the population at risk of developing iron deficiency anemia, mainly children. The drawback, however, is that iron fortification can promote oxidation. To assess the extent of this, palm oil added with heme iron and different antioxidants was used as a model for evaluating the oxidative stability of some bakery products, such as baked goods containing chocolate. The palm oil samples were heated at 220°C for 10 min to mimic the conditions found during a typical baking processing. The selected antioxidants were a free radical scavenger (tocopherol extract (TE), 0 and 500 mg/kg), an oxygen scavenger (ascorbyl palmitate (AP), 0 and 500 mg/kg), and a chelating agent (citric acid (CA), 0 and 300 mg/kg). These antioxidants were combined using a factorial design and were compared to a control sample, which was not supplemented with antioxidants. Primary (peroxide value and lipid hydroperoxide content) and secondary oxidation parameters (p-anisidine value, p-AnV) were monitored over a period of 200 days in storage at room temperature. The combination of AP and CA was the most effective treatment in delaying the onset of oxidation. TE was not effective in preventing oxidation. The p-AnV did not increase during the storage period, indicating that this oxidation marker was not suitable for monitoring oxidation in this model.

Cost-effectiveness of a new combined immunosuppressive and anti-infectious regimen in kidney transplantation.

OBJECTIVES: The aims of this study were to assess the 1-year cost-effectiveness of a new combined immunosuppressive and anti-infectious regimen in kidney transplantation to prevent both rejection and infectious complications. METHODS: Patients (pts) transplanted from January 2000 to March 2003 (Group A) and treated with a conventional protocol were compared with pts submitted to a combined regimen including universal cytomegalovirus (CMV) prophylaxis between April 2003 and July 2005 (Group B). Costs were computed from the hospital accounting system for hospital stays, and official tariffs for outpatient visits. Patients with incomplete costs data were excluded from analysis. RESULTS: Fifty-three patients were analyzed in Group A, and 60 in Group B. Baseline characteristics including CMV serostatus were not significantly different between the two groups. Over 12 months after transplantation, acute rejections decreased from 41.5 percent in Group A to 6.7 percent in Group B (p < .001), and CMV infections from 47 percent to 15 percent (p < .001). Overall, readmissions decreased from 68 percent to 55 percent (p = .160), and average hospital days from 28 +/- 19 to 20 +/- 11 days (p < .007). The average number of outpatient visits decreased from 49 +/- 10 to 39 +/- 8 (p < .001). Average 1-year immunosuppressive and CMV prophylaxis costs (per patient) increased from CHF20,402 +/- 7,273 to 27,375 +/- 6,063 (p < .001), graft rejection costs decreased from CHF4,595 +/- 10,182 to 650 +/- 3,167 (p = .005), CMV treatment costs from CHF2,270 +/- 6,161 to 101 +/- 326 (p = .008), and outpatient visits costs from CHF8,466 +/- 1'721 to 6,749 +/- 1,159 (p < .001). Altogether, 1-year treatment costs decreased from CHF39'957 +/- 16,573 to 36,204 +/- 6,901 (p = .115). CONCLUSIONS: The new combined regimen administered in Group B was significantly more effective, and its additional costs were more than offset by savings associated with complications avoidance.

Suorituskyvyn johtamisen asiantuntijapalvelun tuotteistaminen

Aiempien tutkimusten mukaan suorituskyvyn mittauksella on selvä vaikutus henkilöstön työmotivaatioon ja toiminnan tehokkuuteen. Tämän vaikutuksen taustalla ovat tavoitteiden ymmärtäminen, viestinnän onnistuminen, vaikutusmahdollisuudet, palkitseminen ja motivointi sekä koulutus ja työympäristö. Tutkimuksen tavoitteena on tutkia suorituskyvyn johtamisen asiantuntijapalvelun tuotteistamista. Tutkimuksessa perehdytään ensin asiantuntijapalvelun tuotteistamiseen kirjallisuuden perusteella, jonka jälkeen tätä teoriaa testataan käytännössä tuotteistamalla case-tapauksena oleva suorituskyvyn johtamisen asiantuntijapalvelu. Asiantuntijapalvelut ovat kaikkein abstrakteimpia palveluja, joten niiden tuotteistaminen on vaikeaa, mutta myös samalla erityisen tärkeää. Ne ovat monestitäysin asiakaskohtaisesti räätälöityjä, joka tekee muun muassa niiden hinnoittelusta ja myynnistä vaikeaa. Tuotteistamalla saadaan esimerkiksi asiantuntijapalveluiden tuottamisprosessit ja hinnat vakioitua, jolloin niiden kannattava myynti helpottuu. Tutkimuksen empiria-osassa tuotteistettiin case-tapaus ja tuotteistuksessa seurattiin erästä kirjallisuudessa esitettyä tuotteistusprosessimallia. Tutkimuksessa selvisi, että asiantuntijapalvelun tuotteistusprosessi sisältää useita eri vaiheita, joiden käsittelyyn on varattava aikaa. Lisäksi on tärkeää tutustua asiantuntijapalveluiden tuotteistamiseen jo ennen tuotteistamisen aloittamista. Suorituskyvyn johtamisen asiantuntijapalveluiden tuotteistamisessa voidaanhyvin käyttää yleisiä asiantuntijapalvelun tuotteistamisen teorioita. Tutkimuksesta saatuja tuloksia voidaan käyttää hyväksi suunniteltaessa ja valmisteltaessa asiantuntijapalvelun tuotteistamista ja tutkimus tarjoaa myösneuvoja tuotteistuksen toteutukseen.

Suorituskyvyn menestyksellinen ohjaaminen organisaatiossa

Henkilöstö on yrityksen yksi tärkeimmistä menestystekijöistä ja siksi on tärkeää, että työntekijät ovat sitoutuneita, motivoituneita ja toimivat tehokkaasti. Työn tavoitteena on kehittää organisaatioiden käyttöön suorituskyvyn menestyksellisen ohjaamisen työkalu, jolla voidaan mitata työmotivaation ja toiminnan tehokkuuden taustalla olevia tekijöitä. Kirjallisuudesta, aiemmista tutkimuksista ja haastatteluista selvisi viisi osa-aluetta, jotka vaikuttavat positiivisesti henkilöstön toiminnan tehokkuuteen, työmotivaation ja sitoutumiseen. Osa-alueet ovat tavoitteiden asettaminen, viestintä, henkilöstön vaikutusmahdollisuudet, palkitseminen ja motivointi sekä koulutukseen ja työympäristöön liittyvät tekijät. Jokaisen osa-alueen alle on kerätty kysymyksiä, jotka ovat jaettu kahteen osaan: avainkysymykset ja omavalinnaiset kysymykset. Avainkysymykset ovat sellaisia, joita suositellaan otettavaksi mukaan mittaukseen ja omavalinnaisten kysymysten valinta jää organisaation itsensä päätettäväksi. Näin saadaan organisaatioille mahdollisuus räätälöidä työkalu tarpeisiinsa ja strategiaan sopiviksi. Tutkimukseen empiirinen aineisto kerättiin haastattelemalla. Osallistuneista organisaatioista kaksi oli julkiselta sektorilta ja kuusi yksityiseltä sektorilta. Yksityisen sektorin yritykset koostuvat pienistä, keskisuurista ja suurista yrityksistä. Haastatteluilla kerättiin tietoa työkalun toteutusta ja sisältöä varten. SUMO-kartoituksesta saatuja mittaustuloksia organisaatio voi hyödyntää monella eri tavalla. Esimerkiksi organisaatio voi nähdä osa-alueiden ja toiminnan tehokkuuden kehitystarpeita sekä kuinka henkilöstön toimintaa voidaan tehostaa. Suorituskyvyn mittausjärjestelmän käytöllä on myös positiivisia vaikutuksia mittausosa-alueisiin.

Product Platform Development from the Product Lines' Perspective: Case of Switching Platform

In the era of fast product development and customized product requirements, the concept of product platform has proven its power in practice. The product platform approach has enabledcompanies to increase the speed of product introductions while simultaneously benefit from efficiency and effectiveness in the development and production activities. The product platforms are technological bases, which can be used to develop several derivative products, and hence, the differentiation can be pushed closer to the product introduction. The product platform development has some specific features, which differ somewhat from the product development of single products. The time horizon is longer, since the product platform¿slife cycle is longer than individual product's. The long time-horizon also proposes higher market risks and the use of new technologies increases the technological risks involved. The end-customer interface might be far away, but there is not a lack of needs aimed at the product platforms ¿ in fact, the product platform development is very much balancing between the varying needs set to it by thederivative products. This dissertation concentrated on product platform development from the internal product lines' perspective of a singlecase. Altogether six product platform development factors were identified: 'Strategic and business fit of product platform', 'Project communication and deliverables', 'Cooperation with product platform development', 'Innovativeness of product platform architecture and features', 'Reliability and quality of product platform', and 'Promised schedules and final product platform meeting the needs'. From the six factors, three were found to influence quite strongly the overall satisfaction, namely 'Strategic and business fit of product platform', 'Reliability and quality of product platform', and 'Promised schedules and final product platform meeting the needs'. Hence, these three factors might be the ones a new product platform development unit should concentrate first in order to satisfy their closest customers, the product lines. The 'Project communication and deliverables' and 'Innovativeness of product platform architecture and features' were weaker contributors to the overall satisfaction. Overall, the factors explained quite well the satisfaction of the product lines with product platform development. Along the research, several interesting aspects about the very basic nature of the product platform development were found. The long time horizon of the product platform development caused challenges in the area of strategic fIT - a conflict between the short-term requirements and long term needs. The fact that a product platform was used as basis of several derivative products resulted into varying needs, and hence the match with the needs and the strategies. The opinions, that the releases of the larger product lines were given higher priorities, give an interesting contribution to the strategy theory of powerand politics. The varying needs of the product lines, the strengths of them as well as large number of concurrent releases set requirements to prioritization. Hence, the research showed the complicated nature of the product platform development in the case unIT - the very basic nature of the product platform development might be its strength (gaining efficiency and effectiveness in product development and product launches) but also the biggest challenge (developing products to meet several needs). As a single case study, the results of this research are not directly generalizable to all the product platform development activities. Instead, the research serves best as a starting point for additional research as well as gives some insights about the factors and challengesof one product development unit.

The use of branched ketenedimers in solving the deposit problems related to the internal sizing of uncoated fine paper

Alkyl ketene dimers (AKD) are effective and highly hydrophobic sizing agents for the internal sizing of alkaline papers, but in some cases they may form deposits on paper machines and copiers. In addition, alkenyl succinic anhydrides (ASA)- based sizing agents are highly reactive, producing on-machine sizing, but under uncontrolled wet end conditions the hydrolysis of ASA may cause problems. This thesis aims at developing an improved ketene dimer based sizing agent that would have a lower deposit formation tendency on paper machines and copiers than a traditional type of AKD. The aim is also to improve the ink jet printability of a AKD sized paper. The sizing characteristics ofketene dimers have been compared to those of ASA. A lower tendency of ketene dimer deposit formation was shown in paper machine trials and in printability tests when branched fatty acids were used in the manufacture of a ketene dimer basedsizing agent. Fitting the melting and solidification temperature of a ketene dimer size to the process temperature of a paper machine or a copier contributes to machine cleanliness. A lower hydrophobicity of the paper sized with branched ketene dimer compared to the paper sized with traditional AKD was discovered. However, the ink jet print quality could be improved by the use of a branched ketene dimer. The branched ketene dimer helps in balancing the paper hydrophobicity for both black and color printing. The use of a high amount of protective colloidin the emulsification was considered to be useful for the sizing performance ofthe liquid type of sizing agents. Similar findings were indicated for both the branched ketene dimer and ASA.

Effectiveness of early detection on breast cancer mortality reduction in Catalonia (Spain)

Background: At present, it is complicated to use screening trials to determine the optimal age intervals and periodicities of breast cancer early detection. Mathematical models are an alternative that has been widely used. The aim of this study was to estimate the effect of different breast cancer early detection strategies in Catalonia (Spain), in terms of breast cancer mortality reduction (MR) and years of life gained (YLG), using the stochastic models developed by Lee and Zelen (LZ). Methods: We used the LZ model to estimate the cumulative probability of death for a cohort exposed to different screening strategies after T years of follow-up. We also obtained the cumulative probability of death for a cohort with no screening. These probabilities were used to estimate the possible breast cancer MR and YLG by age, period and cohort of birth. The inputs of the model were: incidence of, mortality from and survival after breast cancer, mortality from other causes, distribution of breast cancer stages at diagnosis and sensitivity of mammography. The outputs were relative breast cancer MR and YLG. Results: Relative breast cancer MR varied from 20% for biennial exams in the 50 to 69 age interval to 30% for annual exams in the 40 to 74 age interval. When strategies differ in periodicity but not in the age interval of exams, biennial screening achieved almost 80% of the annual screening MR. In contrast to MR, the effect on YLG of extending screening from 69 to 74 years of age was smaller than the effect of extending the screening from 50 to 45 or 40 years. Conclusion: In this study we have obtained a measure of the effect of breast cancer screening in terms of mortality and years of life gained. The Lee and Zelen mathematical models have been very useful for assessing the impact of different modalities of early detection on MR and YLG in Catalonia (Spain).

Involvement of family physicians in structured programs for chronic diseases or multi-morbidity in Switzerland.

The increasing prevalence of chronic diseases and multi-morbidity represents challenges for health systems worldwide. In that perspective, the current organization of healthcare delivery, fragmentation of care, limited use of evidence-based guidelines and patients'insufficient empowerment are some reasons explaining the current limited effectiveness of the management of chronically ill patients. Based on theoretical models such as the Chronic Care Model (CCM), initiatives targeting improvements in the care of patients with chronic diseases have been implemented worldwide since more than a decade. Their development in Switzerland, a health system where more than half of practices are still single handed [6], is only recent and infrequent. Structured programs for patients with chronic diseases or multimorbidity usually propose patient-centered interventions and consider an integrative multidisciplinary approach. Currently, little is known on the existence of such programs and on the role of family physicians (FPs)within these programs, in Switzerland. The objective of this study was to identify and describe current structured programs targeting chronic diseases or multi-morbidity in Switzerland. This may help in examining innovative approaches that are only developed locally but would deserve wider interest for further implementation. We conducted a telephone-based survey between June and November 2013 and contacted systematically key institutions, informants and stakeholders nationwide and in the 26 cantons...

Cost-effectiveness of early detection of breast cancer in Catalonia (Spain)

Background: Breast cancer (BC) causes more deaths than any other cancer among women in Catalonia. Early detection has contributed to the observed decline in BC mortality. However, there is debate on the optimal screening strategy. We performed an economic evaluation of 20 screening strategies taking into account the cost over time of screening and subsequent medical costs, including diagnostic confirmation, initial treatment, follow-up and advanced care. Methods: We used a probabilistic model to estimate the effect and costs over time of each scenario. The effect was measured as years of life (YL), quality-adjusted life years (QALY), and lives extended (LE). Costs of screening and treatment were obtained from the Early Detection Program and hospital databases of the IMAS-Hospital del Mar in Barcelona. The incremental cost-effectiveness ratio (ICER) was used to compare the relative costs and outcomes of different scenarios. Results: Strategies that start at ages 40 or 45 and end at 69 predominate when the effect is measured as YL or QALYs. Biennial strategies 50-69, 45-69 or annual 45-69, 40-69 and 40-74 were selected as cost-effective for both effect measures (YL or QALYs). The ICER increases considerably when moving from biennial to annual scenarios. Moving from no screening to biennial 50-69 years represented an ICER of 4,469€ per QALY. Conclusions: A reduced number of screening strategies have been selected for consideration by researchers, decision makers and policy planners. Mathematical models are useful to assess the impact and costs of BC screening in a specific geographical area.

Epithelial sodium transport and its control by aldosterone: the story of our internal environment revisited.

Transcription and translation require a high concentration of potassium across the entire tree of life. The conservation of a high intracellular potassium was an absolute requirement for the evolution of life on Earth. This was achieved by the interplay of P- and V-ATPases that can set up electrochemical gradients across the cell membrane, an energetically costly process requiring the synthesis of ATP by F-ATPases. In animals, the control of an extracellular compartment was achieved by the emergence of multicellular organisms able to produce tight epithelial barriers creating a stable extracellular milieu. Finally, the adaptation to a terrestrian environment was achieved by the evolution of distinct regulatory pathways allowing salt and water conservation. In this review we emphasize the critical and dual role of Na(+)-K(+)-ATPase in the control of the ionic composition of the extracellular fluid and the renin-angiotensin-aldosterone system (RAAS) in salt and water conservation in vertebrates. The action of aldosterone on transepithelial sodium transport by activation of the epithelial sodium channel (ENaC) at the apical membrane and that of Na(+)-K(+)-ATPase at the basolateral membrane may have evolved in lungfish before the emergence of tetrapods. Finally, we discuss the implication of RAAS in the origin of the present pandemia of hypertension and its associated cardiovascular diseases.

Selection of internal control genes for real-time quantitative PCR in ovary and uterus of sows across pregnancy

Reproductive traits play a key role in pig production in order to reduce costs and increase economic returns. Among others, gene expression analyses represent a useful approach to study genetic mechanisms underlying reproductive traits in pigs. The application of reverse-transcription quantitative PCR requires the selection of appropriate reference genes, whose expression levels should not be affected by the experimental conditions, especially when comparing gene expression across different physiological stages.

Clinical effectiveness of direct anterior restorations-A meta-analysis.

OBJECTIVES: This is the first meta-analysis on the efficacy of composite resin restorations in anterior teeth. The objective of the present meta-analysis was to verify whether specific material classes, tooth conditioning methods and operational procedures influence the result for Class III and Class IV restorations. MATERIAL AND METHODS: The database SCOPUS and PubMed were searched for clinical trials on anterior resin composites without restricting the search to the year of publication. The inclusion criteria were: (1) prospective clinical trial with at least 2 years of observation; (2) minimal number of restorations at last recall=20; (3) report on drop-out rate; (4) report of operative technique and materials used in the trial, and (5) utilization of Ryge or modified Ryge evaluation criteria. For the statistical analysis, a linear mixed model was used with random effects to account for the heterogeneity between the studies. p-Values smaller than 0.05 were considered to be significant. RESULTS: Of the 84 clinical trials, 21 studies met the inclusion criteria, 14 of them for Class III restorations, 6 for Class IV restorations and 1 for closure of diastemata; the latter was included in the Class IV group. Twelve of the 21 studies started before 1991 and 18 before 2001. The estimated median overall success rate (without replacement) after 10 years for Class III composite resin restorations was 95% and for Class IV restorations 90%. The main reason for the replacement of Class IV restorations was bulk fractures, which occurred significantly more frequently with microfilled composites than with hybrid and macrofilled composites. Caries adjacent to restorations was infrequent in most studies and accounted only for about 2.5% of all replaced restorations after 10 years irrespective of the cavity class. Class III restorations with glass ionomer derivates suffered significantly more loss of anatomical form than did fillings with other types of material. When the enamel was acid-etched and no bonding agent was applied, significantly more restorations showed marginal staining and detectable margins compared to enamel etching with enamel bonding or the total etch technique; fillings with self-etching systems were in between of these two outcome variables. Bevelling of the enamel was associated with a significantly reduced deterioration of the anatomical form compared to no bevelling but not with less marginal staining or less detectable margins. The type of isolation (absolute/relative) had a statistically significant influence on marginal caries which, however, might be a random finding.

Effect of prestorage curing on storage life, internal and external qualities of sweet orange (Citrus sinensis)

Orange fruits from two seasons, in April and August 2006 representing late 2005 and early 2006 harvests respectively were cured in hot air at 36-37(0)C to 1%, 3%, 5% and 7% weight loss before storage at 28(0)C and 86% relative humidity (RH). The fruits were observed for incidence of decay, further weight loss, juice content, firmness or softening of the peel, total soluble solids (TSS), pH, titratable acidity, and colour during storage. Curing reduced the incidence of decay. All control fruits were rotten by day 21 in August harvest while 22.5% of the control was rotten by day 56 in the April harvest. Storage life was extended beyond 56 days in fruits cured with 1, 3, 5 and 7% in April harvest as there was no decay throughout, while decay incidence in August harvest was 88.9, 61.1, 22.2 and 31.3% in 1, 3, 5 and 7% respectively. Penicillium digitatum, Phytophthora sp., Alternaria citri and Collectotrichum gloeosporioides were among decay causing moulds detected. Control fruits lost more weight during storage than cured fruits did. Fruit rind hardening was more noticed in the control and those cured to 1% weight loss, especially from the April harvest. It was insignificant in other treatments in both trials. Titratable acidity, pH, juice content and TSS were not affected by the treatment. Colour change to yellow was however retarded by curing. Curing to 5% weight loss was best for decay control and quality retention.