Effect of Steam and Smoke Cooking Processes on Web-Foot Octopus (Amphioctopus sp.) Home Meal Replacement Product

In Korea, the web-foot octopus (Amphioctopus sp.) is commonly consumed as jjukkumi bokkeum, a spicy stir-fried octopus dish. Using steaming and smoking methods, we made jjukkumi bokkeum home meal replacement (HMR) products. The response surface methodology (RSM) was employed to optimize the steam and smoke processes. Quick freezing was applied to freeze the test product at −35 °C. Then, the physicochemical, biological, nutritional characteristics, and shelf-life of the test HMR products were evaluated. The optimal conditions for steaming and smoking were 95 °C for 2 min and 70 °C for 11 min, respectively. The pH, volatile basic nitrogen content, and thiobarbituric acid-reactive substances content decreased after steaming and smoking, indicating that these processes maintained these parameters well. Sensory evaluation revealed that there were no changes in these characteristics after freezing and reheating. Further, the test HMR products contained the daily nutritional requirements of macro and micronutrients, as well as amino acids and fatty acids. The shelf-life of the HMR products was estimated to be 15 months. The findings of this study indicate that the application of steam and smoke processes to produce a jjukkumi bokkeum HMR product results in a high-quality product with a long shelf-life.

Surviving an Extensive Burn Injury Using Advanced Skin Replacement Technologies

There have been significant improvements in the technology available for treating extensive burns in the past decade. This case presents two unique, skin replacement technologies that were used to treat an 86% surface area flame burn in a pediatric patient. A temporary dermal replacement, known as “Novosorb™ Biodegradable Temporizing Matrix” was first used to stabilize the burn injury and remained in place for approximately three months. Given the large burn size and lack of available donor skin for grafting, a permanent skin replacement product known as “Self-Assembled Skin Substitute (SASS)” was then utilized to cover the burns. SASS is a novel technology that was developed to replace skin as an autologous skin graft and is currently available in Canada through a clinical trial for major burns. Ultimately, the concurrent use of these two technologies allowed for the unprecedented survival of a child following an extensive and life-threatening burn injury.

Development of a Home Meal Replacement Product Containing Braised Mackerel (Scomber japonicus) with Radish (Raphanus sativus)

The coronavirus disease pandemic has contributed to increasing convenience in food preferences. Home meal replacement (HMR) products are ready-to-eat, -cook, or -heat foods, providing convenience for consumers. We developed a HMR product containing mackerel as a protein- and lipid-rich source using various food-processing technologies to maintain its nutritional content and prolong shelf life. The HMR product contained mackerel, radish, and sauce in a ratio of 5:1:4. Raw frozen mackerels were thawed by using a high-frequency defroster before being braised using a superheated steam roaster. Response surface methodology was employed to obtain the optimal heating conditions of 181 °C for 9 min. The final test HMR product was packed in a polypropylene plastic bowl prior to freezing at −35 °C for 1 h using a quick freezing system. The HMR product developed using these technologies exhibited stable microbiological and chemical properties for 90 days of storage. Sensory scores gradually decreased with increasing storage temperature and time. Protein content in the HMR product was 13%, 40% of which comprised essential amino acids; lipid content was 13.4%, 18% of which was composed of docosahexaenoic acid. The HMR product can preserve its quality and is considered safe for consumption for up to 40 months of storage at −18 °C.

Pediatric Fibrinogen PART II—Overview of Indications for Fibrinogen Use in Critically Ill Children

Bleeding is frequently seen in critically ill children and is associated with increased morbidity and mortality. Fibrinogen is an essential coagulation factor for hemostasis and hypofibrinogenemia is an important risk factor for bleeding in pediatric and adult settings. Cryoprecipitate and fibrinogen concentrate are often given to critically ill children to prevent bleeding and improve fibrinogen levels, especially in the setting of surgery, trauma, leukemia, disseminated intravascular coagulopathy, and liver failure. The theoretical benefit of fibrinogen supplementation to treat hypofibrinogenemia appears obvious, yet the evidence to support fibrinogen supplementation in children is sparce and clinical indications are poorly defined. In addition, it is unknown what the optimal fibrinogen replacement product is in children and neonates or what the targets of treatment should be. As a result, there is considerable variability in practice. In this article we will review the current pediatric and applicable adult literature with regard to the use of fibrinogen replacement in different pediatric critical care contexts. We will discuss the clinical indications for fibrinogen supplementation in critically ill children and the evidence to support their use. We summarize by highlighting current knowledge gaps and areas for future research.

Fit-for-Purpose VSI Modelling Framework for Process Simulation

The worldwide shortage of natural sand has created a need for improved methods to create a replacement product. The use of vertical shaft impact (VSI) crushers is one possible solution, since VSI crushers can create particles with a good aspect ratio and smooth surfaces for use in different applications such as in construction. To evaluate the impact a VSI crusher has on the process performance, a more fit-for-purpose model is needed for process simulations. This paper aims to present a modelling framework to improve particle breakage prediction in VSI crushers. The model is based on the theory of energy-based breakage behavior. Particle collision energy data are extracted from discrete element method (DEM) simulations with particle velocities, i.e., rotor speed, as the input. A selection–breakage approach is then used to create the particle size distribution (PSD). For each site, the model is trained with two datasets for the PSDs at different VSI rotor tip speeds. This allows the model to predict the product output for different rotor tip speeds beyond the experimental configurations. A dataset from 24 different sites in Sweden is used for training and validating the model to showcase the robustness of the model. The model presented in this paper has a low barrier for implementation suitable for trying different speeds at existing sites and can be used as a replacement to a manual testing approach.

Assessment of Electrolyte Replacement in Critically Ill Patients During a Drug Shortage

Purpose: The purpose of this study was to determine if national drug shortages of electrolyte replacement products negatively impact patient care. Methods: This study was a single-center, retrospective, observational cohort of adults admitted to the medical, surgical, or trauma intensive care unit (ICU) that were ordered or would have qualified for the general or continuous renal replacement therapy electrolyte replacement protocol (ERP) between April 2017 and August 2018. In October 2017, ERP use was suspended and enteral replacement was promoted due to inability to maintain consistent inventory of intravenous replacement products. The primary objective was to compare the percentage of patient days that at least 1 critically low value of potassium, magnesium, and/or phosphorus existed between protocolized and nonprotocolized electrolyte replacement. Secondary objectives included characterizing the ratio of enteral replacement to duration of critically low electrolyte values during protocolized and nonprotocolized electrolyte replacement. Results: A total of 288 patients were included. The mean percentage of ICU days with low electrolyte levels in the protocolized period was significantly higher than in the nonprotocolized period (21.4% vs 17.5%, P = .0238). There was a negative relationship between the total electrolyte replacement that was given enterally and the percentage of patient days with critically low values indicating that as enteral replacement increased, percentage of days with low values decreased. The association between percentage of enteral replacement and days with critically low electrolyte values was significantly lower in the protocolized period. Conclusion: Intravenous electrolyte replacement product shortages did not result in an increased incidence of critically low electrolyte values. Enteral replacement was associated with a decreased incidence of low electrolyte values.