Impact Of Different Stages Research Articles

Teacher noticing within the context of lesson study: a systematic review and prospective trends

PurposeTeacher noticing is a critical aspect of teaching competence that has garnered significant scholarly attention. This systematic review aims to comprehensively analyze the integration of teacher noticing into lesson study, exploring how different stages of lesson study influence the development of teacher noticing.Design/methodology/approachThis article systematically reviews 15 empirical studies on teacher noticing within the context of lesson study, focusing on research design, subjects, methods, theoretical frameworks and the specific impact of different stages of lesson study on teacher noticing.FindingsThe review reveals a geographical concentration of studies in Western countries, particularly in the United States, with a relative scarcity of research in East Asian contexts. Most studies focus on pre-service teachers, employ qualitative methods and are grounded in Van Es’s (2011) Learning to Notice framework. The findings indicate that different stages of lesson study significantly influence teacher noticing, particularly in the planning, teaching and reflection stages, where shifts in focus and depth of noticing are evident.Research limitations/implicationsThis paper explores how various lesson study stages impact teacher noticing development. It offers future research directions and calls for more cross-cultural studies. Certain activities within classroom research may restrict attention development, particularly when these activities fail to encourage in-depth cognitive analysis across all stages sufficiently. Future research should explore how to avoid these limitations in the classroom research process and design more effective strategies to support deep observation and analysis by teachers at each stage. In the reflection stage of classroom research, certain factors may restrict the focus on student thinking.Practical implicationsBy synthesizing the existing research into a comprehensive narrative, we provide an essential foundation for future studies on teacher noticing within lesson study contexts. This work not only charts the historical development of the field but also encourages more profound and actionable research engagement with the nuanced processes of teacher observation and reflection during lesson studies.Originality/valueThis paper explores how various lesson study stages impact teacher noticing development. It offers future research directions and calls for more cross-cultural studies and a combination of quantitative and qualitative methods to fully understand the effects of lesson studies on teacher noticing.

Age, gender, and infectious status-wise assessments of hematological parameters among patients with dengue infection

BackgroundThe aim of this study was to examine the impact of different stages of dengue infection on immune cell counts among dengue patients and to compare them with cases of non-dengue febrile illness. MethodsThe recruited patients were divided into two groups: the first group served as a control (n = 55), representing non-dengue febrile illness, and the second group was identified as dengue febrile illness (n = 149), which was further divided into three groups based on infection stage. Blood samples were collected from the selected patients and subjected to blood cell component analysis. To find IgG and IgM as well as the dengue virus non-structural antigen-1 (NS1), an immunochromatographic test (ICT) kit was utilized. Additionally, a hematological analyzer was used to determine complete blood cell counts (CBC). Data was thoroughly analyzed using Graph Pad Prism 6 software. The differences in means of different groups were calculated by applying the student's t-test. ResultsThe findings revealed the presence of severe leucopenia and thrombocytopenia at stages 1 and 2, accompanied by lymphopenia at stage 1. Group comparisons indicated that only teenagers exhibited a significantly lower white blood cell count compared to older individuals, while no significant differences were observed in lymphocytes, platelets, and monocytes across all age groups. Comparing different age groups of normal individuals to dengue-infected patients, the results unveiled that leucopenia was most severe in adults, followed by teenagers and children, with no significant difference in the elderly. Furthermore, adults showed the greatest degree of thrombocytopenia, followed by teens and kids, with the elderly showing the greatest degree of thrombocytopenia. Adults and teens showed extreme neutrophilia, whereas young children and the elderly showed no discernible abnormalities. Elderly patients experienced a marked decrease in monocyte count, a phenomenon not observed in other age groups. ConclusionIn conclusion both, leucopenia & thrombocytopenia, are most severe in stages 1 and 2, whereas neutrophilia & lymphopenia are predominantly severe in stage 1. These results imply that the consequences associated with dengue infection are more severe in the early stages and tend to ameliorate as the patient progresses toward recovery.

Impact of the First Year of the COVID-19 Pandemic on Pediatric Emergency Department Attendance in a Tertiary Center in South Italy: An Interrupted Time-Series Analysis.

The evidence shows a reduction in pediatric emergency department (PED) flows during the early stages of the COVID-19 pandemic. Using interrupted time-series analysis, we evaluated the impact of different stages of the pandemic response on overall and cause-specific PED attendance at a tertiary hospital in south Italy. Our methods included evaluations of total visits, hospitalizations, accesses for critical illnesses and four etiological categories (transmissible and non-transmissible infectious diseases, trauma and mental-health) during March-December 2020, which were compared with analogous intervals from 2016 to 2019; the pandemic period was divided into three segments: the "first lockdown" (FL, 9 March-3 May), the "post-lockdown" (PL, 4 May-6 November) and the "second lockdown" (SL, 7 November-31 December). Our results showed that attendance dropped by a mean of 50.09% during the pandemic stages, while hospitalizations increased. Critical illnesses decreased during FL (incidence rate ratio -IRR- 0.37, 95% CI 0.13, 0.88) e SL (IRR 0.09, 95% CI 0.01, 0.74) and transmissible disease related visits reduced more markedly and persistently (FL: IRR 0.18, 95% CI 0.14, 0.24; PL: IRR 0.20, 95% CI 0.13, 0.31, SL: IRR 0.17, 95% CI 0.10, 0.29). Non-infectious diseases returned to pre-COVID-19 pandemic levels by PL. We concluded that that the results highlight the specific effect of the late 2020 containment measures on transmissible infectious diseases and their burden on pediatric emergency resources. This evidence can inform resource allocation and interventions to mitigate the impact of infectious diseases on pediatric populations and the health-care system.

Is the risk for COVID-19 outcomes the same for all patients with chronic kidney disease? A retrospective study

Coronavirus disease 2019 (COVID-19) emerged at the end of 2019 and quickly spread worldwide. Among the various comorbidities associated with severe disease, chronic kidney disease (CKD) has been identified as one of the leading conditions. However, it is not yet clear whether all stages of CKD pose the same risk for severe COVID-19 infection. Therefore, the objective of this study was to assess the impact of different stages of CKD on the clinical characteristics, disease progression, and outcomes of COVID-19.
 Methods. This retrospective study focused on CKD patients who were admitted with COVID-19. We analyzed various factors including demographic data, comorbidities, symptoms, physical findings, laboratory test results, length of hospital stay, and in-hospital outcomes. These factors were evaluated based on the different stages of CKD.
 Results. A total of 284 CKD patients infected with SARS-CoV-2 were evaluated and compared to 395 COVID-19 patients with normal kidney function. Among the CKD patients, 86 were receiving dialysis. We observed significantly higher levels of C-reactive protein, procalcitonin, D-dimer, and ferritin, as well as a significantly lower lymphocyte count, in the CKD groups compared to the control group. There were significant differences among the CKD groups in terms of biochemical markers, duration of hospital stay, rates of ICU admission, and mortality. However, we did not find significant differences between dialysis and non-dialysis CKD patients regarding the length of hospital stay, need for ICU admission, and number of deceased patients.
 Conclusions. The presence and severity of CKD should be considered crucial factors for predicting the risk of COVID-19. Patients with late-stage CKD who are hospitalized with COVID-19 require increased awareness and close monitoring to reduce rates of ICU admission and mortality.

Multi-task Joint Learning to Enhance Named Entity Recognition

Named Entity Recognition (NER) models have achieved good performance in recent years but also have some shortcomings. Existing models regard NER as a sequence labeling task for label prediction, without considering the impact of different stages in the entity recognition process on the final result. NER can be viewed as two separate subtasks: boundary detection task and type prediction task. The two subtasks can transmit information and cooperate in the process of entity recognition, so the synergy of the two subtasks is beneficial to NER. In this paper, we propose a method to split the NER task into multiple subtasks and use the information of each subtask to enhance the NER task. According to the characteristics of different subtasks, we use different feature extraction method models to extract structural information useful for this task effectively. Using the information extracted from each subtask or the final results of the subtasks, the performance of NER was enhanced through the gating network. We conducted extensive experiments on the CONLL2003 dataset, and the experimental results show that our proposed multi-task joint learning enhances the effectiveness of the named entity recognition model.

Evolution and mitigation of vehicular emissions due to India's Bharat Stage Emission Standards – A case study from Delhi

Vehicular emissions are the major contributors of particulate matter and ozone pollution, which has a greater negative impact on human health, climate and vegetation. Bharat Stage emission standards (BSES) are implemented in India to reduce vehicular emissions and there are several stages of BS norms (BS–I, BS-II, BS-III, BS-IV and BS-VI) proposed since 2000. Currently BS-VI emission norms are implemented nationwide from 2020 onwards. The BS standards came into force in prior advance in Delhi region compared to the other cities. Hence, the current study presents an introspection of the impact of several stages of BS norms in reducing the vehicular emissions in Delhi. The impact is studied through the survival fraction of the vehicles in use with different norms, the fleet average emission factors and the fuel consumption for the years 2012–2022. The analysis shows that the emissions from light-duty vehicles (LDV) are significantly higher than the emissions from heavy-duty vehicles (HDV). In the 2017–2022 age group, the PM2.5 and VOC emissions showed a gradual decrease when compared to the 2012–2017 age group, whereas the CO, NOx, PM10 and BC emissions were fluctuating. Overall, in the case of LDV, except for NOx, all the emissions are controlled as an impact of different stages of BS norms and in the case of HDV almost all the pollutants are regulated. The NOx emissions show a positive correlation with vehicular population and the correlation has not changed with the different norms. Though the NOx emission limits are regulated tightly at each stage of the norms, the increase in NOx emissions is unavoidable. This is due to the discrepancy between real-world conditions and laboratory testing. Enforcing BS-VI standards is expected to eliminate this discrepancy and the advanced aftertreatment technologies adopted in BS-VI engines should interact in a balanced way such that the control of one pollutant should minimize the emission of other pollutants.

Impact of the COVID-19 pandemic on psychosocial work factors and emotional exhaustion among workers in the healthcare sector: a longitudinal study among 1915 Dutch workers

ObjectivesThis study aims to investigate across subgroups of healthcare workers (1) the changes in psychosocial working conditions and emotional exhaustion during the pandemic compared with the situation before, and (2)...

Impact of COVID-19 on psychosocial work factors and emotional exhaustion among healthcare workers

Abstract Background Healthcare workers are at risk to develop mental health problems and to experience adverse psychosocial working conditions during the COVID-19 pandemic. This study aims to investigate across subgroups of healthcare workers i) differences in psychosocial working conditions and emotional exhaustion, ii) changes in psychosocial working conditions and emotional exhaustion during the pandemic compared to the situation before, and iii) impact of different stages of the COVID-19 pandemic in terms of hospital pressure on psychosocial working conditions and emotional exhaustion. Methods Data on psychosocial working conditions and emotional exhaustion of five measurements from 1,915 healthcare workers participating in the longitudinal study ‘the Netherlands Working Conditions Survey- COVID-19’ were used. Three subgroups were defined: working with COVID-19 patients, working with other patients, and not working with patients. For each measurement, hospital pressure was determined. Linear mixed models were fitted to analyze the differences across subgroups of healthcare workers. Results Healthcare workers working with patients, in particular COVID-19 patients, had more unfavorable psychosocial working conditions than those not working with patients. Psychosocial working conditions deteriorated among those working with patients compared to pre-COVID-19, but no changes were found for emotional exhaustion. An increasing hospital pressure resulted in improved job autonomy and emotional demands among healthcare workers working with COVID-19 patients, but did not result in differences in other working conditions and emotional exhaustion. Conclusions Psychosocial working conditions deteriorated for healthcare workers working with (COVID-19) patients during the pandemic compared to the situation before the pandemic, while emotional exhaustion did not change in these subgroups. This shows the importance of interventions to improve working conditions of healthcare workers. Key messages

Impact of baseline renal function on the efficacy and safety of different Anticoagulants in Atrial Fibrillation Patients – A cohort study

BackgroundVitamin K antagonists and different direct oral anticoagulants (DOACs) have different renal clearance rates. However, the impact of different stages of chronic renal impairment on the efficacy and safety of warfarin, dabigatran, rivaroxaban, apixaban, and edoxaban in atrial fibrillation (AF) patients remains unclear.MethodsThis study enrolled AF patients from the Chang Gung Research Database. The study endpoints included thromboembolic events, major/fatal bleeding, gastrointestinal (GI) bleeding and intracranial hemorrhage (ICH). The risks of time to study endpoints between groups were compared using a Cox proportional hazards regression model with adjustment.ResultsThis study enrolled 3525 patients with moderate renal impairment (30 ≤ creatinine clearance (CrCl) < 60 mL/min), 2846 patients with mild renal impairment (60 ≤ CrCl < 90 mL/min) and 1153 patients with CrCl ≥ 90 mL/min. Over the 3.3 ± 0.9 years follow-up period, the cumulative thromboembolic events rates and the cumulative event rates of major/fatal bleeding and ICH did not differ among the warfarin and different DOAC groups at different stages of chronic renal impairment. The annual incidences of thromboembolic events, major/fatal bleeding, GI bleeding, and ICH were similar among the warfarin and different DOAC groups at different stages of renal impairment.ConclusionThere did not appear to be major differences in bleeding or thromboembolic risk compared to warfarin in AF patients across a range of degree of renal failure when appropriate dose reductions of the DOACs are made.

Bayesian Framework for Multi-Wave COVID-19 Epidemic Analysis Using Empirical Vaccination Data

The COVID-19 pandemic has highlighted the necessity of advanced modeling inference using the limited data of daily cases. Tracking a long-term epidemic trajectory requires explanatory modeling with more complexities than the one with short-time forecasts, especially for the highly vaccinated scenario in the latest phase. With this work, we propose a novel modeling framework that combines an epidemiological model with Bayesian inference to perform an explanatory analysis on the spreading of COVID-19 in Israel. The Bayesian inference is implemented on a modified SEIR compartmental model supplemented by real-time vaccination data and piecewise transmission and infectious rates determined by change points. We illustrate the fitted multi-wave trajectory in Israel with the checkpoints of major changes in publicly announced interventions or critical social events. The result of our modeling framework partly reflects the impact of different stages of mitigation strategies as well as the vaccination effectiveness, and provides forecasts of near future scenarios.

The impact of different stages of water treatment process on the number of selected bacteria

Critical infrastructure facilities play an important role in ensuring the safety of human life. The present paper provides an overview of the legal framework for critical infrastructure facilities regarding protection against epidemiological risk. Based on test results for treated and raw water samples (n = 8973) and samples collected in water treatment plants at individual stages of the technological process, the effectiveness of water treatment processes used at the plants was assessed with regard to selected pathogens, i.e., Coliforms bacteria, Escherichia coli, Enterococcus faecalis and Clostridium perfringens. It was demonstrated that the level of bacteriological contamination of river water is mainly determined by the number of fecal bacteria Coliforms bacteria and Enterococcus faecalis, and the proportion of individual types of pathogens in water from both the river and infiltration wells does not change significantly throughout the year and presents the following order: Coliforms bacteria > Clostridium perfringens ≈ Enterococcos faecalis. It was shown that the process of soil infiltration is highly effective in removing pathogenic bacteria (99% on average) and may present an alternative to intermediate processes of water treatment, comparable to filtration on DynaSand filters. The level of microbial removal was high at the intermediate stage of water treatment, i.e., preliminary coagulation in settling tanks and filtration on sand filters. Following subsequent technological processes, namely disinfection with UV light and gas chlorine, or ozonation and filtration on activated carbon, there was a 100% reduction in microbiological pathogens in the water analyzed, which is an essential requirement to ensure the safety of drinking water.

Dietary fiber, starch, and sugars in bananas at different stages of ripeness in the retail market.

The goal of this work was to evaluate changes in dietary fiber measured by the traditional enzymatic-gravimetric method (AOAC 991.43) and the more recently accepted modified enzymatic-gravimetric method (AOAC 2011.25), mono- and disaccharides, and starch as a function of assessed ripeness in a controlled study of a single lot of bananas and in bananas at the same assessed stages of ripeness from bananas purchased in retail stores, from different suppliers. Sugars, starch, and dietary fiber were analyzed in bananas from a single lot, at different stages of ripeness, and in retail samples at the same assessed stages of ripeness. Mean fiber measured by the traditional enzymatic-gravimetric method (EG) was ~2 g/100g and not affected by ripeness. Mean fiber assessed with the recently modified method (mEG) was ~18 g/100g in unripe fruit and decreased to 4–5 g/100g in ripe and ~2 g/100g in overripe bananas. Slightly ripe and ripe bananas differed by ~1.1 g/100g in the controlled single-lot study but not among retail samples. There was a large increase in fructose, glucose and total sugar going from unripe to ripe with no differences between ripe and overripe. Aside from stage of ripeness, the carbohydrate composition in retail bananas is likely affected by differences in cultivar and post-harvest handling. Results from this study demonstrate the importance of measuring dietary fiber using the mEG approach, developing more comprehensive and sensitive carbohydrate analytical protocols and food composition data, and recognizing the impact of different stages of maturity and ripeness on carbohydrate intake estimated from food composition data.

Adverse Maternal and Neonatal Outcomes in Women With Elevated Intrapartum Temperature Complicated by Histological Chorioamnionitis at Term: A Propensity-Score Matched Study.

Background: Elevated intrapartum temperature has been widely proven to be associated with adverse clinical outcomes in both mothers and neonates. Histological chorioamnionitis (HCA), the inflammation of chorion and amniotic membranes, is commonly observed in those with elevated intrapartum temperature. Thus, we aimed to explore whether the combination of HCA would further affect the pregnancy outcomes in those with intrapartum temperature ≥ 37.5°C.Methods: This retrospective cohort study was conducted at the International Peace Maternity and Child Health Hospital (IPMCH), including all full-term women with intrapartum temperature ≥ 37.5°C from Jan 2017 to Jan 2019. Patients were divided in to HCA group or control group according to placental pathology results, and we used 1:1 propensity score matching (PSM) to reduce the effects of potential confounding factors between the two groups. Univariate and multivariable logistic regression were used to identify the association between HCA and different adverse maternal and neonatal outcomes.Results: We formed a propensity-score matched cohort containing 464 women in each group. Higher positive rate of mycoplasma (14.01% vs. 7.33%, p = 0.001) was found in the vaginal secretion culture of women in the HCA group. After adjusting for various baseline clinical characteristics, women with HCA were more likely to end their delivery by cesarean section (AOR = 1.55, 95% CI: 1.05–2.28), and puerperal morbidity (AOR = 2.77, 95% CI: 1.44–5.33) as well as prolonged hospitalization (AOR = 1.56, 95% CI: 1.12–2.17) were more likely to be observed in the HCA group. The existence of HCA might also be associated with neonatal sepsis (AOR = 2.83, 95% CI: 1.14–7.04) and NICU admission (AOR = 1.40, 95% CI: 1.04–1.87) in newborns. In the study on the impact of different stages of HCA, we found that both maternal and neonatal outcomes would not be affected by mild HCA (stage I), while HCA of stage III was associated with increased need for neonatal respiratory support and elevated likelihood of prolonged hospitalization in neonates.Conclusions: Elevated intrapartum temperature complicated by HCA might be related to the elevated occurrence of several adverse maternal and neonatal outcomes, except those with HCA of stage I. Advanced HCA stage correlated with a worse prognosis.

The prognostic impact of different stages of acute kidney injury in patients with decompensated cirrhosis: a prospective cohort study.

To assess the impact of the different stages of acute kidney injury (AKI) on the prognosis of patients hospitalized with decompensated cirrhosis. This was a prospective cohort study of consecutive patients admitted in two tertiary hospitals in southern Brazil. Participants were considered eligible if they were admitted for acute decompensation of cirrhosis. The main exposure factor was the onset of AKI. AKI stages were defined according the European recommendations. The outcomes evaluated were survival time and death rates at 28 and 90 days from hospital admission. A χ2 test was used to compare mortality between groups. Kaplan-Meier survival analyses were undertaken assessing time to event as days from AKI diagnosis to death or liver transplant. Two hundred and five patients were included in the study, and 121 met the criteria for AKI. Patients with AKI 1b, AKI 2 and AKI 3 had higher 90-day mortality than patients without AKI (P = 0.008, P < 0.001 and P < 0.001, respectively). However, there was no difference in 90-day mortality when patients with AKI 1a were compared with those without AKI (P = 0.742). The mean survival of patients without AKI was higher than that of patients with AKI 1b (591.4 and 305.4 days, respectively, P = 0.015), while there was no significant difference between the mean survival of patients without AKI and that of patients with AKI 1a (591.4 and 373.6 days, respectively, P = 0.198). Only AKI ≥1b seems to substantially impact mortality of patients hospitalized for acute decompensation of cirrhosis.

Brexit and the Banking Sector: The Stock Market Reaction of UK and European Banks

We examine the impact of three events related to Brexit on stock prices of UK and European banks: i) the announcement of the referendum date, ii) the referendum result, and iii) the appointment of Theresa May as the British Prime Minister. Our results show that bank shareholders reacted positively to the announcement of the referendum date and to the election of Theresa May as Prime Minister, whereas their reaction to the referendum outcome was negative. The analysis also demonstrates that the impact of different stages of Brexit on the stock market is more dependent on geographical factors than on firm-specific characteristics. The only exception is bank size, which positively affects bank shareholder choices. Our results have important regulatory and managerial implications: new political risks should be appropriately included into scenario analysis and the ability to assess and manage this risk should be taken into account in strategic planning and risk management.

Modeling exponential decay in maximum capacitance across specified flight patterns in small aircraft

&#x0D; &#x0D; &#x0D; With increased autonomy being an integral part of un- manned aerial system (UAS), during flight a vehicle needs to have an accurate estimation of its state of health and capabilities to perform and achieve mission success with utmost safety. Batteries are of key importance in electric-propulsion aircraft and are its most pertinent re- source. It is important to know the state of charge of the battery not only because the health state is directly re- lated to the flight profiles flown by the vehicle, but also because the state of charge of the vehicle and its opera- tional condition must be estimated after each flight.&#x0D; In this work a methodology is presented to generate pre- dictions for flight plans that experience anomalies, or un- expected system failure in due to a parasitic load in a specified stage of the flight that must return to its starting point of origin. We begin by describing the procedures by which a sequence of steps will be carried out to expo- nentially weigh the impact of different stages of a flight towards thermal strain on the capacitance Cmax of the battery during each flight.&#x0D; &#x0D; &#x0D;

Stages of Decision Automation: Impact on Operators’ Role, Awareness and Monitoring

The study investigated the impact of different stages of decision automation (action selection vs. action implementation) on participants’ monitoring, situation awareness (SA), and role definition in a multitask simulation. It was hypothesized that particularly because of being out-of-the-loop when working with full automation (action implementation) operators might feel accountable for the overall task, have an enhanced SA and show frequent information sampling. In contrast, operators working with partial automation might define their role limited to the only task not supported by automation, leading to limited SA and overall monitoring. Results reveal an automation benefit for performance but a decreased SA induced by automation. No impact of automation was found for monitoring. The only direct impact of stage of automation was on participants’ perceived role regarding active interventions into the system. In summary, different stages of decision automation lead to different role perceptions but with marginal effects on performance and monitoring.

Study of the effect of COPD on the quality of life of patients according to the results of the Cat - test in outpatient practice

The article analyzes the impact of chronic obstructive pulmonary disease (COPD) on the quality of life of patients according to the results of clinical and instrumental examination and ante - testing using the integral CAT-test.Objective. Study of the effect of COPD on the quality of life in outpatient practice based on the results of the integral CAT-test. Materials and methods. The article analyzes the impact of chronic obstructive pulmonary disease (COPD) on the quality of life of patients according to the results of clinical and instrumental examination and ante - testing using the integral CAT-test.Results. The primary treatment of patients with a long history of COPD in stages II and III recorded a greater impact of the respiratory component on the quality of life. Because of complex therapy (inhaled bronchodilators and glucocorticosteroids, antibiotics according to indications, non - pharmacological methods of pulmonary rehabilitation, respiratory gymnastics, and school for patients with COPD) during 1 year of follow - up, there were significant changes in the indicators of quality of life. In patients with the sum of scores on the SAT-test up to 20 showed a decrease in the number and severity of clinical symptoms of respiratory status, and the average value of forced expiratory volume in 1 s (FEV1) remained almost at the same level with a significant improvement in the overall quality of life. In patients with a score of 21 or higher, the FEV1 level after 1 year significantly increased by 12.2%, which is apparently due to a higher level of patient compliance and the effect of pulmonary rehabilitation measures.Conclusion. The results of assessing the impact of different stages of COPD on the quality of life of patients in outpatient practice will improve the monitoring of the course of the disease and optimize the prognosis, state the effectiveness of complex therapy and adjust the dispensary observation plan.

Cocoa Bean Proteins-Characterization, Changes and Modifications due to Ripening and Post-Harvest Processing.

The protein fractions of cocoa have been implicated influencing both the bioactive potential and sensory properties of cocoa and cocoa products. The objective of the present review is to show the impact of different stages of cultivation and processing with regard to the changes induced in the protein fractions. Special focus has been laid on the major seed storage proteins throughout the different stages of processing. The study starts with classical introduction of the extraction and the characterization methods used, while addressing classification approaches of cocoa proteins evolved during the timeline. The changes in protein composition during ripening and maturation of cocoa seeds, together with the possible modifications during the post-harvest processing (fermentation, drying, and roasting), have been documented. Finally, the bioactive potential arising directly or indirectly from cocoa proteins has been elucidated. The “state of the art” suggests that exploration of other potentially bioactive components in cocoa needs to be undertaken, while considering the complexity of reaction products occurring during the roasting phase of the post-harvest processing. Finally, the utilization of partially processed cocoa beans (e.g., fermented, conciliatory thermal treatment) can be recommended, providing a large reservoir of bioactive potentials arising from the protein components that could be instrumented in functionalizing foods.

Impact of different stages of intrauterine inflammation on outcome of preterm neonates: Gestational age-dependent and -independent effect.

ObjectiveTo investigate the impact of different stages of intrauterine inflammation (IUI) on neonatal outcomes, before and after adjusting for gestational age (GA) and other perinatal confounders.MethodsThis was an observational, prospective, single-center cohort study including all eligible neonates with GA < 35 weeks and/or birth weight ≤ 1500 g born at a 3rd level Neonatal Intensive Care Unit between 2011 and 2014. Pathological patterns of placenta, membranes and cord were classified according to Redline’s criteria. Multivariable linear and logistic regression models were applied, either including or not GA among the covariates.ResultsOf the 807 enrolled neonates, 134 (16.6%) had signs of IUI: among these, 54.5% showed just histological chorioamnionitis (HCA), 25.4% had HCA + funisitis (FUN) stage 1, and 20.1% had HCA + FUN stage 2–3. At univariate analysis, HCA increased the risk for retinopathy of prematurity (ROP) and bronchopulmonary dysplasia, while FUN (any stage) had a deleterious impact on all outcomes investigated. After adjustment for covariates not including GA, HCA was a risk factor only for ROP (OR = 2.8, CI: 1–7.8), while FUN (any stage) was still associated with increased ORs for all outcomes (p <0.01). Upon inclusion of GA in the regression model, the results differed remarkably. HCA was associated with lower risk for mechanical ventilation (OR = 0.3, CI: 0.1–0.7) and need for surfactant (OR = 0.5, CI: 0.2–0.9), while FUN (any stage) worsened clinical conditions at birth (p <0.05), increased the risk for early-onset sepsis (p <0.01), and increased the length of mechanical ventilation (FUN stage 2–3 only, RC = 6.5 days, CI: 2–11). No other outcome was affected.ConclusionsIUI, especially FUN, negatively impact most neonatal morbidities, but its effect is partially reverted adjusting for GA. Considered that GA is an intermediate variable interposed between prenatal causes of prematurity and outcomes, the appropriateness of adjusting for GA may be questionable.