Steep Time Research Articles

On Timor Island, East Nusa Tenggara, nixtamalization and pre-gelatinization were used as Bose Corn instantiation techniques

Abstract The province of East Nusa Tenggara is an archipelago province. Timor Island is one of the islands in the province of East Nusa Tenggara, where most of the population consumes corn as a staple food besides rice. The typical food on Timor Island, known since ancient times, is Bose Corn. The Bose corn cooking procedure is time-consuming and water-intensive. Timor Island is an area with dry land and a dry climate. Therefore, it is necessary to introduce technology that can shorten the cooking time by using less water. The instantiation process of bose corn using nixtamalization and pre-gelatinization methods is used as a technology to overcome this problem. The nixtamalization method using 0.4% (w/v) Ca(OH)2 in the steeping time treatment (0, 2, 4, 6, 8, and 10 hours) showed an increase in the color components (brightness, redness, and yellowness) in a raw and cooked instant bose corn. The grain yield of instant bose corn experienced a significant increase, namely 53.63% in the treatment without steeping time (0 hours) to 72.21% in the treatment of 10 hours steeping time. Water absorption increased to 352.36% at a steeping time of 6 hours but decreased to 320.17% at 10 hours of steeping time. Instantiation of bose corn using the pre-gelatinization method with different treatments of cooking time (60, 90, 120, 150, and 180 minutes) showed almost the same brightness value in raw and cooked instant bose corn. Differences in the color components redness and yellowness are indicated by the color towards yellowish red on raw instant bose corn and the color towards yellowish green on cooked instant bose corn. The grain yield of instant bose corn in large the pre-gelatinization method decreased significantly with the cooking time, namely 91.38% at 60 minutes to 75.23% at 180 minutes. The water absorption capacity of instant bose corn has increased but not significantly. It proves that the discoloration of instant bose corn in raw and cooked conditions using nixtamalization and pre-gelatinization methods was not significantly different. The grain yields produced from these two methods have no significant difference in water absorption. Thus, these two instantiation methods can be applied to the people of the island of Timor to make instant bose corn.

Caffeoylquinic acid profiling: comparative analysis in yerba mate, Indian camphorweed, and stevia extracts with emphasis on the influence of brewing conditions and cold storage in yerba mate infusion.

Herbal infusions exhibit diverse pharmacological effects, such as antioxidant, anti-inflammatory, anticancer, antihypertensive, and antineurodegenerative activities, which can be attributed to the high content of phenolic compounds (e.g., caffeoylquinic acids (CQAs)). In this study, we used ultraperformance liquid chromatography to determine the content of CQAs in the methanolic extracts of model herbs, namely, yerba mate (Ilex paraguariensis), stevia (Stevia rebaudiana), and Indian camphorweed (Pluchea indica (L.) Less.). The results revealed that yerba mate had the highest total CQA content (108.05 ± 1.12 mg/g of dry weight). Furthermore, we evaluated the effect of brewing conditions and storage at 4 °C under dark and light conditions on the antioxidant property and total phenolic and CQA contents of a yerba mate infusion. The analysis of the yerba mate infusions prepared with different steeping times, dried leaf weights, and water temperatures revealed that the amount of extracted CQAs was maximized (∼175 mg/150 mL) when 6 g of dried leaves were steeped in hot water for 10 min. A total of 10-day refrigerated storage resulted in no significant changes in the antioxidant activity and total phenolic and CQA contents of an infusion kept in a brown container (dark). However, the antioxidant properties and total phenolic and CQA contents were negatively affected when kept in a clear container, suggesting the detrimental effect of light exposure. Our study provides practical recommendations for improving the preparation and storage of herbal infusions, thus catering to the needs of consumers, food scientists, and commercial producers. Moreover, it is the first study of the influence of light exposure on the content of crucial quality attributes within plant-based beverages.

Chemical, physical, and sensory properties of nixtamalized oat tortillas

AbstractBackground and ObjectivesWhile alkaline nixtamalization has historically been used for corn, this process may have application in other cereals. Drawbacks to wider use include the lengthy steep time, as well as the volume of alkaline wastewater produced. This study evaluated a novel, waste‐effluent‐free nixtamalization process for oat (Avena sativa) masa, and compared properties of oat masa and tortillas prepared with 1%, 1.5%, and 2% lime, with and without steeping.FindingsA minimal‐water‐addition, 45‐min simmering process, without steeping, was effluent‐free, and produced oat tortillas comparable to those produced using a traditional overnight steep. The pH increased significantly with increasing lime content (r = .982). Consumer overall‐liking scores did not significantly differ across treatments, though appearance scores were significantly higher for 2% lime samples (p < .05), which were significantly darker and more yellow, based on L* and b* values. Masa adhesiveness means ranged from 1.49 to 1.52 N, with no significant differences between the no‐steep treatments. Higher lime addition (1.5%–2%) in the no‐steep process significantly improved tortilla flexibility, based on extensibility and rollability scores, though tortilla rupture force did not vary significantly across treatments. Tortilla rollability scores at 3‐days were lowest ( = 1.1 + 0.31, indicating less cracking) for the 1.5%–2% lime no‐steep treatments, which were significantly better than the steeped treatment ( = 3.7 + 0.48). Consumers rated the steeped sample as significantly less flexible. B‐vitamins were negatively impacted by increasing lime, while calcium increased significantly with lime addition.ConclusionsThe no‐steep, effluent‐free nixtamalization process produced oat tortillas with good masa and tortilla texture, which were not significantly different in consumer liking than tortillas produced via a traditional process.Significance and NoveltyThis research suggests nixtamalization can be applied to other grains in a shorter, environmentally friendly process, with broader commercial applicability.

High-density controlled environment agriculture (CEA-HD) air distribution optimization using computational fluid dynamics (CFD)

In this paper, the indoor environment of a small-scale high-density controlled environment agriculture (CEA-HD) space was simulated using computational fluid dynamics. Spatial modelling of the indoor environment considering the influential phenomena (e.g. transpiration and photosynthesis) over the indoor temperature, relative humidity, carbon dioxide (CO2) concentration, and airflow velocity is still challenging. These indoor environment conditions were computed for a 3D model of a CEA-HD experimental space while simultaneously modelling crop airflow impingement, transpiration and photosynthesis. The crops being grown were represented in the model as porous media zones and their exchanges with the indoor air were modelled using user defined functions. The air distribution parameters and configuration were optimized using a simplified 2D model to overcome the steep computational time, and associated cost, of 3D simulation. The objective function of the optimization problem relied on a correlation analysis of the simulation output. The optimization of the 2D model yielded an airfoil configuration that reduced the mean airflow speed and relative humidity variations between the cultivation tiers while achieving higher mean velocities (≈1.9 m·s−1) at a lower inlet speed (8 m·s−1). The proposed modelling and optimization approach is a small step forward towards model-based design and operation of CEA-HD production spaces.

The effect of ascorbic acid and lemon juice on the extraction of metals from green tea, health risk assessment

The total heavy metal concentration (Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn) in green tea leaves and metals leached into tea infusions of pure water with the addition of ascorbic acid and lemon juice at various temperatures (70, 80, and 100 °C) and steeping times (3, 5, and 7 min), were determined. Metal concentrations were analyzed by atomic absorption spectrometry and the flame technique (FAAS). Mean total concentrations of Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn were < LOD, <LOD, 0.198, 4.527, 67.51, 333.7, 2.588, <LOD, 10.23 μg/g, respectively. The highest percentage of extraction in different solutions was in the case of Mn (up to 100%). The risk for adults through consumption of tea was mainly contributed by Mn, and non-carcinogenic hazard quotient (HQ) was slightly higher than 1 when infusions were heated to 100 °C. High percentages of Ni were extracted in pure water compared to water with addition, regardless of tea steeping time, followed by Cu in pure water and water with lemon juice. Fe was poorly extracted in all applied solutions; the highest percentage of extraction (17.21%) was determined in lemon juice solutions of at 100 °C during a steeping time of 7 min.

Anti-nutrient composition of starch isolated from red and white sorghum cultivars subjected to different steeping times.

Sorghum (Sorghum bicolor) is a staple food that provides a major source of calories to large segments of the population living in semi-arid tropics of Africa and Asia. Steeping is an age-long process among all the available food processing techniques known to improve nutritional qualities, palatability and consumer appeal of sorghum. The effects of steeping periods on the anti-nutrient composition of starches from two varieties of sorghum (red and white) were investigated. Sorghum grains steeped for 6, 12, 18 and 24 h with water were processed into starch and sample from unsteeped sorghum served as control. The starch samples were analysed for anti-nutrients components using standard analytical procedure. Anti-nutrients investigated varied with cultivars and increased steeping time. Hydrogen cyanide observed was in the range of (1.34 to 1.86 mg/kg), tannin (1.30 to 4.82 mg/g), saponin (6.10 to 13.05 mg/g), oxalate (0.43 to 0.90 mg/g), phytate (2.15 to 9.06 mg/g), cardiac glycoside (9.30 to 13.35 mg/g), terpenoid (13.50 to 18.99 mg/g) and alkaloid (34.10 to 50.31%). The objective is to determine the anti-nutrients composition of starch from red and white sorghum. There was no significant difference between starches from the two cultivars of sorghum (red and white) in most of the parameters investigated. However, the red cultivar recorded higher values in some of the anti-nutrients investigated. The anti-nutrient levels significantly reduce with increase in steeping time thereby improving the bioavailability of mineral and other nutrients present in sorghum. Mixture of two varieties (red and white) could find applications in food formulations.

OPTIMISATION OF STEEPING AND GERMINATION TIMES ON THE ANTIOXIDANT POTENTIALS OF PIGEON PEA (CAJANUS CAJAN)

In an attempt to maximize the antioxidant potentials of pigeon peas, the effect of steeping and germination times on the antioxidant content and radical scavenging activities of pigeon pea was investigated using response surface methodology. Using the central composite rotatable design (CCRD), pigeon pea seeds were soaked in water (2-28 h) and germinated (9-111 h). Thirteen samples were generated and analyzed for phenols, flavonoids, reducing power, 1, 1, Diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging activity and ferric reducing antioxidant power (FRAP). Results revealed that the quadratic effects of both steeping and fermentation times were significant for predicting the phenols, flavonoids, reducing power, and FRAP while only the steeping time had a significant quadratic effect on DPPH. Significant correlation coefficients (r) were found to exist between the antioxidants and most of the antioxidant activities. The optimum steeping and germination times obtained were 15 and 96 hours respectively; predicted values for phenols, flavonoids, reducing power, and FRAP were 50.09 mg/100g, 26.56mg/100 g, 0.75 µg/ml, and 69.30 µmol/g respectively.

Physicochemical Characteristics of Butterfly Pea Flower Petals Steep Obtained at Different Steeping Temperature and Time

Flower is an important part of the plant containing phytochemical compounds, especially the phenolic acids, flavonoids, and anthocyanin that can be used as natural antioxidants. Phytochemical compounds are usually drawn by steeping the flower petals in hot water. Indeed, different temperatures and steeping times would affect the yield of phytochemicals obtained. The butterfly pea flower is one of edible flowers that brings antioxidant activity due to the presence of phytochemical compounds, namely flavonoids and phenolic acids. Nevertheless, there have been limited studies dedicated to the search of steeping condition of butterfly pea flower petals in water. Thus, this study aimed to determine the time and temperature of steeping to produce the butterfly pea step with preferred physicochemical characteristics. The result indicates that butterfly pea flower petals which undergo steeping at 60°C for 45 minutes produce antioxidant activity with an IC50 value of 251.89 ± 32.02 ppm. Furthermore, the butterfly pea flower steep produced had blue to purple color with °Hue of 277.06 ±2.55, 1.23 ± 0.07 mg/L of total monomeric anthocyanin content, 6.83 ± 0.02 of pH and 138.42 ± 15.88 mg GAE / g sample of total phenolic content. Keywords: antioxidant; butterfly pea flower; steep; temperature; time

Wet vacuum impregnation assisted in malting; its implication on steeping degree, germination energy and malt properties

SummaryThe wet vacuum impregnation (WVI) was used in malting process to reduce soaking period. To implement WVI during steeping, vacuum pressure of 500 mmHg for 300 s, was applied twice on five Thai barley cultivars. The effect of WVI on germination energy, moisture content, phenolic acids, antioxidant activity (AOA) and malt quality were examined relative to Central European Commission for Brewing Analysis (MEBAK) malting condition. Moisture content in barley soaked by WVI and MEBAK steeping method were in the range of 36.1–39.9% and 39.9–47.8%, respectively with germination energy of 96–97%. The physicochemical properties of malt from steeping via WVI and MEBAK showed the malts were protein‐rich cultivars, adequate β enzyme and low α amylase activities, hence, low‐malt extract. Total fermentable sugars were relative higher in MEBAK malts than WVI malts. Nevertheless, steeping by WVI had higher free and bound phenolic acids, which led to higher AOA via ABSTS and DPPH assays in some barley cultivars than MEBAK. This research highlights the WVI did not limit barley gemination and the potential of this technology in malting process by limiting steeping time. Further study is required to reduce air‐rest period and optimise condition to achieve moisture content of 40–45% in soaked barley.

Effect of steeping time on the anti-nutrients composition of starch from red and white sorghum cultivars

Sorghum (Sorghum bicolor) is a staple food that provides a major source of calories to large segments of the population living in semi-arid tropics of Africa and Asia. Steeping is an age-long process among all the available food processing techniques known to improve nutritional qualities, palatability and consumer appeal of sorghum. The study investigate the effects of steeping periods on the anti-nutrient composition of starches from two varieties of sorghum (red and white) were investigated. Sorghum grains steeped for 6, 12, 18 and 24 hours with water were processed into starch and sample from unsteeped sorghum served as control. The starch samples were analysed for anti-nutrients components using standard analytical procedure. Anti-nutrients investigated varied with cultivars and increased steeping time. Hydrogen cyanide observed was in the range of (1.34 to 1.86 mg/kg), tannin (1.30 to 4.82 mg/g), saponin (6.10 to 13.05 mg/g), oxalate (0.43 to 0.90 mg/g), phytate (2.15 to 9.06 mg/g), cardiac glycoside (9.30 to 13.35 mg/g), terpenoid (13.50 to 18.99 mg/g) and alkaloid (34.10 to 50.31%). There was no significant difference between starches from the two cultivars of sorghum (red and white) in most of the parameters investigated. However, the red cultivar recorded higher values in some of the anti-nutrients investigated. The anti-nutrient levels significantly reduce with increase in steeping time thereby improving the bioavailability of mineral and other nutrients present in sorghum. Mixture of two varieties (red and white) could find applications in food formulation.

The circle of reentry: Characteristics of trigger-substrate interaction leading to sudden cardiac arrest.

Sudden cardiac death is often caused by ventricular arrhythmias driven by reentry. Comprehensive characterization of the potential triggers and substrate in survivors of sudden cardiac arrest has provided insights into the trigger-substrate interaction leading to reentry. Previously, a "Triangle of Arrhythmogenesis", reflecting interactions between substrate, trigger and modulating factors, has been proposed to reason about arrhythmia initiation. Here, we expand upon this concept by separating the trigger and substrate characteristics in their spatial and temporal components. This yields four key elements that are required for the initiation of reentry: local dispersion of excitability (e.g., the presence of steep repolarization time gradients), a critical relative size of the region of excitability and the region of inexcitability (e.g., a sufficiently large region with early repolarization), a trigger that originates at a time when some tissue is excitable and other tissue is inexcitable (e.g., an early premature complex), and which occurs from an excitable region (e.g., from a region with early repolarization). We discuss how these findings yield a new mechanistic framework for reasoning about reentry initiation, the "Circle of Reentry." In a patient case of unexplained ventricular fibrillation, we then illustrate how a comprehensive clinical investigation of these trigger-substrate characteristics may help to understand the associated arrhythmia mechanism. We will also discuss how this reentry initiation concept may help to identify patients at risk, and how similar reasoning may apply to other reentrant arrhythmias.

Immunostimulatory and Immunorestorative Effects of Leaf Extract and Fractions of Musanga cecropioides on Immunocompetent and Experimentally Immunocompromised Mice

• Musanga cecropioides boosted immune stimulation in immunocompetent animals • M. cecropioides brought about fast rate of restoration of immune status • M. cecropioides stimulated immune response to (sheep red blood cell) SRBC antigen Stimulation of the immune system against disease causing agents and restoration of immune functions in immunodeficiency disease state are essential for maintaining good health. Objective : This study investigated the immunomodulatory effects of the leaf extract and fractions of Musanga cecropioides in immunocompetent and induced immunocompromised animal models. Humoral immune stimulatory effect of the extract and its fractions at 200 and 400 mg∙kg −1 against sheep red blood cells (SRBCs) antigen was determined in both immunocompetent and cyclophosphamide (80 mg∙kg −1 ) immunosuppressed animals. The effect of the most active fraction on leucopoiesis was also determined following high dose cyclophosphamide (300 mg∙kg −1 ) suppression of the immune system. Levamisole at 2.5 mg∙kg −1 was used as the reference drug throughout the study. The extract dose dependently stimulated the humoral immune response to SRBC antigen in immunocompetent animals; however, its stimulatory effect was not significant ( P > 0.05). In the immunosuppressed model, the extract at 400 mg∙kg −1 evoked significant ( P < 0.05) increase in antibody titer value with a corresponding 67% immune-restorative effect. The ethyl acetate fraction (EAF) maintained the most active fraction with significant ( P < 0.05) antibody stimulatory effect in immunocompetent and immunosuppressed animals. Similarly, higher recovery rate was demonstrated by the EAF as shown by steep time recovery curve in high dose immunosuppressed animals. The EAF at 200 and 400 mg∙kg −1 showed above 50% leucopoiesis just like the reference drug (2.5 mg∙kg −1 levamisole) against 33.83% shown by the immune-suppressed control group. M. cecropioides boosted immune stimulation in immunocompetent animals and brought about fast rate of restoration of immune status in immunocompromised animals.

EFFECT OF STEEPING TIME AND LACTIC ACID CONCENTRATION ON EXTRACTION OF STARCH FROM CORN FLOUR

The study was conducted to evaluate the effect of different steeping times (2h, 4 h, and 6 h), steeping temperature (40oC, 45 oC, 50 oC, and 55 oC) and lactic acid concentration (T0=control sample, T1=250ml, T2=350ml, T3=450ml and for T4=550ml) on starch recovery from corn flour. Corn flour was stepped with different lactic acid concentrations (T0=control sample, T1=250ml, T2=350ml, T3=450ml, and T4=550ml) and fixed SO2 (0.2 g for all samples) over the different steeping time (2h, 4 h, and 6 h) and different steeping temperature (40 o C, 45 o C, 50 o C and 55 o C). The result showed that the maximum yield of starch obtained in sample T4 at 55 oC for 6 h of steeping, i.e 32.53%, and minimum amount of starch yield obtained in sample T0 at 40 oC for 2 h of steeping, i.e 19.10%. On the other side maximum amount of fiber yield was obtained in sample T0 at 40 o C for 2 h of steeping, i.e 61.56%, and the minimum amount of fiber yield was obtained in sample T4 at 55 o C for 6 h of steeping, i.e 30.15%.

Estimated daily intake of epichlorohydrin and certain heavy metals of bagged and loose black teas

This study aimed to determine the levels of epichlorohydrin (ECH) and some metals in 3 brands of bagged and loose black teas which are widely marketed in Alexandria markets, Egypt, and estimate the acceptable daily intake as a safety indicator. Gas chromatography–mass spectrometry results revealed that ECH levels significantly differed between the tested brands steeped for 2 min and tea bags contained higher levels than in loose teas and the levels increased by increasing the steep time. These levels of ECH in all the tested brands either in tea bags or loose teas were higher than the guideline value of 0.10 μg/L. Also, the results illustrated that the adding of sucrose or washing of bags with deionized water for 1 min significantly decreased the levels of ECH. In addition, inductively coupled plasma optic emission spectrometry (ICP–OES) results illustrated that the levels of Al, Pb, and Cd were too low in infusions compared to the established guidelines. Because of the high consumption of tea in Alexanria city, Egypt, it is necessary to determine the contribution of tea to the daily dietary intake of ECH, Al, Pb and Cd. In case of the bagged teas, the calculated daily intake of ECH was on average about 55.37 times greater than that in loose teas. The consumption of both bagged and loose teas infusion could not pose a risk for population as the health hazard index was < 1. It can be concluded that consumers who prefer to use tea bags should rinse these bags before preparing the tea brewer, and do not increase the steeping time to more than 2 min.

Multi-Response Optimization of the Malting Process of an Italian Landrace of Rye (Secale cereale L.) Using Response Surface Methodology and Desirability Function Coupled with Genetic Algorithm.

Rye is used in some applications in the food and beverage industry and for the preparation of functional foods. It is an interesting raw material in malting and brewing due to its characteristic contribution to the beer's color, turbidity, foam and aroma. The aim of this work was to optimize the micro-malting process of a rye landrace. The response surface methodology (RSM) was applied to study the influence of three malting parameters (germination time, germination temperature and degree of steeping) on the quality traits of malted rye. Long germination times at high temperatures resulted in an increase in the extract and Kolbach index. The model for the apparent attenuation limit showed a particular pattern, whereby time and temperature inversely influenced the response. The lowest viscosities were determined in the worts produced from highly modified malts. Optimization of the variables under study was achieved by means of a desirability function and a genetic algorithm. The two methodologies provided similar results. The best combination of parameters to optimize the malting process on the rye landrace under study was achieved at 6 days, 12 °C and 44 g/100 g.

A Method for Representing Non-Standard Waveform in Factory Tests Using Impulse Waveforms

The standard 1.2/50 lightning impulse test has been important for factory testing equipment and evaluating their performance in electrical systems. In practice, however, such equipment is subject to non-standard waveform (NSW) of high frequencies, which may not be covered by standard tests. To overcome this difficulty, the present article outlines a method that simulates NSW in laboratory tests. Based on multiresolution wavelet analysis, the method considers the correlation between amplitude and entropy in the decomposition levels between waveforms. To that end, changes are proposed to the following parameters of standard impulse tests: amplitude, cut-off instant, and front time. The results show that, mostly, the combination of a lightning impulse waveform (LIW) with impulse waves cut at different times, sufficiently represent the NSW. Only when the NSW's density falls predominantly in a frequency range above 3.125 MHz, will there be need for a complementary LIW with a steep front time. The method's application allows manufacturers and concessionaires to subject the equipment to conditions that properly represent the NSW effects, through lightning impulse tests carried out at the factory.

An Experimental Design on Coffee Extraction Factors Impacting the Measurable Percent of Total Dissolved Solids in Solution

There are numerous techniques and technologies used in the brewing of coffee today. This study is aimed to design an umbrella experiment to examine the impacting key factors consistent across all methods of extraction. These factors were identified as: grind size, roast type, steep time, grind to water as a mass-to-mass ratio and temperature. Samples were prepared by grinding the beans, weighing the beans and adding the appropriate amount to a rectangular glass vessel. Distilled water was used. French press was selected as the brewing technique. No agitation after the addition of grind was allowed. Water was heated to initial temperature and added to the vessel and a timer was started. Upon time completion aliquots were taken and analysed using a prism-based automatic temperature compensation (ATC) refractometer. Minitab 19.2020.1 (64-bit) was used for analysis of variance and optimisation. In the initial design of experiments, the five factors were considered at different levels. Three factors found significant in impacting %TDS (total dissolved solids) were: total steep time, grind-to-water ratio and roast type. To further refine the experiments, 23 full-factorial design was conducted for these three factors. Finally, optimisation was done to determine the factor levels to produce a cup of coffee for the target %TDS of 1.26. This research found that it is best to use medium roast coffee that is ground fine with a 0.08 grind-to-water ratio, with an initial temperature of 195 Fahrenheit in a French press, and the ideal steep time is 7 min. Previous studies have focused on the extraction methods. In this study, the method of extraction has been removed as a variable. Hence, the findings are very useful for food industry.

Establishing robotic bariatric surgery at an academic tertiary hospital: a learning curve analysis for totally robotic Roux-en-Y gastric bypass

The use of robotic systems in bariatric surgery has constantly increased over the last years. However, beside its technical advantages in morbidly obese patients the conclusive role of robotics in bariatric and metabolic surgery is still under controversial debate. This is an analysis of prospectively collected data of consecutive patients undergoing fully robotic Roux-en-Y gastric bypasses (TR-RYGB) during the first year after implementation of a robotic bariatric program at a tertiary university hospital. All patients were operated by a previously untrained robotic but experienced laparoscopic bariatric surgeon using the daVinci Xi system (Intuitive Surgical, Sarl). Data recording included patient characteristics, operative and functional outcomes, complications and learning curves for surgeon and assistants. In total, 80 patients underwent primary or revisional robotic bariatric surgery. Seventy-two patients (90%) received a TR-RYGB. There were no major complications, re-interventions or readmissions. The overall complication rate was 2.5% (Clavien–Dindo grade I and II). The overall operation time was 140.7 ± 24.6 min and decreased significantly from the first to the last decade of procedures (procedure 1–10: 171.2 ± 26.3 min versus procedure 63–72: 116.0 ± 10.9 min, p < 0.0001). A stabilization of the learning curve was observed after 30 procedures for the surgeon and after five procedures for the bedside assistant. With immediate effect, TR-RYGB is a safe procedure with low complication rates for an experienced laparoscopic bariatric surgeon without prior robotic skills. Learning curves are steep and operation times can be effectively decreased by increasing the experience of the surgeon.

Steep repolarization time gradients in pig hearts cause distinct changes in composite electrocardiographic T-wave parameters.

The T wave of the electrocardiogram (ECG) reflects ventricular repolarization. Repolarization heterogeneity is associated with reentrant arrhythmias. Several T-wave markers (including QT interval) have been associated with ventricular arrhythmias, but studies linking such markers to underlying local repolarization time (RT) inhomogeneities are lacking. We aimed to investigate the relation of several T-wave markers to controlled drug-induced regional RT gradients in intact pig hearts. Repolarization time gradients were created by regional infusion of dofetilide and pinacidil in four atrially paced porcine Langendorff-perfused hearts placed inside a torso tank. From the 12-lead ECG on the torso tank, the mean, maximum, and dispersion (max-min) of QTtime , JTtime , Tpeak-end , Twidth , TQratio , dV/dtmax , Tarea , Tamp , and T-upslope duration were determined, as well as upslope end difference between leads V1 and V6 . Temporal T-wave parameters Tpeak-end , Twidth, and TQratio show a significant and high correlation with RT gradient, best reflected by mean value. Tarea (mean, max and dispersion) and dV/dtmax dispersion show only a moderate significant correlation. T-upslope duration shows a significant correlation in particular for mean values. Mean, maximum, or dispersion of QTtime and V1 -V6 upslope end difference were not significantly correlated with RT gradient. Composite 12-lead ECG T-wave parameters Tpeak-end , Twidth , TQratio , upslope duration, and Tarea show a good correlation with underlying RT heterogeneity, whereas standard clinical metrics such as QTtime do not reflect local RT heterogeneity. The composite T-wave metrics may thus provide better insights in arrhythmia susceptibility than traditional QTtime metrics.

Time trend and Bayesian mapping of multiple myeloma incidence in Sardinia, Italy

A few reports have described increasing trends and spatial distribution of multiple myeloma (MM). We used a validated database including the 1606 cases of MM diagnosed in Sardinia in 1974–2003 to explore its time trend, and we applied Bayesian methods to plot MM probability by administrative unit on the regional map. Over the 30 years of observation, the MM standardized incidence rate (standard world population, all ages) was 2.17 × 10–5 (95% CI 2.01–2.34), 2.29 (95% CI 2.06–2.52) among men, and 2.06 (95% CI 1.83–2.28) among women. MM incidence increased by 3.3%/year in 1974–2003, in both males and females, particularly among the elderly and in the high incidence areas. Areas at risk tended to cluster in the north-eastern part of the region. A higher proportion of elderly in the resident population, but not socioeconomic factors, nor livestock farming, was associated with higher incidence rates. The steep upward time trend and the spatial clustering of MM suggest interactions between genetic and environmental determinants that might be more efficiently investigated in the areas at risk.