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Background: The concept of a clean label is difficult to define, even in common language, as the interpretation of what a “clean” food is differs from one person to another and from one organisation to another. The lack of a unique definition and regulations of what the term “clean” means, along with the growing consumer demand for more “natural” and healthier foods, is posing new challenges for manufacturers and ingredient producers. The meat industry, in particular, has been affected by this new movement owing to negative attitudes and feelings consumers associate with consuming processed meat products. Scope and approach: The review scope is to describe attributes and associations around the “clean” label term by analysing the most recent ingredients, additives and processing methods currently available for meat manufacturers. Their application in meat, plant-based alternatives and hybrid meat/plant products, current limitations and challenges presented in consumer perception, safety and potential impacts on product quality are also presented. Key findings and conclusions: The availability of a growing number of “clean” label ingredients provides a new suite of approaches that are available for application by meat processors to help overcome some of the negative connotations associated with processed meat products and also support plant-based meat alternatives and hybrids.

Although new technologies have increased the efficiency and convenience of medical care, patients still struggle to identify specialized outpatient departments in Chinese tertiary hospitals due to a lack of medical knowledge. The objective of our study was to develop a precise and subdividable outpatient triage system to improve the experiences and convenience of patient care. We collected 395,790 electronic medical records (EMRs) and 500 medical dialogue groups. The EMRs were divided into 3 data sets to design and train the triage model (n=387,876, 98%) and test (n=3957, 1%) and validate (n=3957, 1%) it. The triage system was altered based on the current BERT (Bidirectional Encoder Representations from Transformers) framework and evaluated by recommendation accuracies in Xinhua Hospital using the cancellation rates in 2021 and 2022, from October 29 to December 5. Finally, a prospective observational study containing 306 samples was conducted to compare the system's performance with that of triage nurses, which was evaluated by calculating precision, accuracy, recall of the top 3 recommended departments (recall@3), and time consumption. With 3957 (1%) records each, the testing and validation data sets achieved an accuracy of 0.8945 and 0.8941, respectively. Implemented in Xinhua Hospital, our triage system could accurately recommend 79 subspecialty departments and reduce the number of registration cancellations from 16,037 (3.83%) of the total 418,714 to 15,338 (3.53%) of the total 434200 (P<.05). In comparison to the triage system, the performance of the triage nurses was more accurate (0.9803 vs 0.9153) and precise (0.9213 vs 0.9049) since the system could identify subspecialty departments, whereas triage nurses or even general physicians can only recommend main departments. In addition, our triage system significantly outperformed triage nurses in recall@3 (0.6230 vs 0.5266; P<.001) and time consumption (10.11 vs 14.33 seconds; P<.001). The triage system demonstrates high accuracy in outpatient triage of all departments and excels in subspecialty department recommendations, which could decrease the cancellation rate and time consumption. It also improves the efficiency and convenience of clinical care to fulfill better the usage of medical resources, expand hospital effectiveness, and improve patient satisfaction in Chinese tertiary hospitals.

Flaccid paralysis in the upper extremity is a severe motor impairment after stroke, which exists for weeks, months, or even years. Electroacupuncture treatment is one of the most widely used TCM therapeutic interventions for poststroke flaccid paralysis. However, the response to electroacupuncture in different durations of flaccid stage poststroke as well as in the topological configuration of the cortical network remains unclear. The objectives of this study are to explore the disruption of the cortical network in patients in different durations of flaccid stage and observe dynamic network reorganization during and after electroacupuncture. Resting-state networks were constructed from 18 subjects with flaccid upper extremity by partial directed coherence (PDC) analysis of multichannel EEG. They were allocated to three groups according to time after flaccid paralysis: the short-duration group (those with flaccidity for less than two months), the medium-duration group (those with flaccidity between two months and six months), and the long-duration group (those with flaccidity over six months). Compared with short-duration flaccid subjects, weakened effective connectivity was presented in medium-duration and long-duration groups before electroacupuncture. The long-duration group has no response in the cortical network during electroacupuncture. The global network measures of EEG data (sPDC, mPDC, and N) indicated that there was no significant difference among the three groups. These results suggested that the network connectivity reduced and weakly responded to electroacupuncture in patients with flaccid paralysis for over six months. These findings may help us to modulate the formulation of electroacupuncture treatment according to different durations of the flaccid upper extremity.

Hybrid plant and meat (HPM) products, in which a portion of meat is substituted with alternative plant protein-containing ingredients, offer a promising option for flexitarian consumers seeking to increase plant protein consumption while continuing to enjoy the sensory qualities of meat products. This study evaluated the effects of faba bean protein (FBP), pea protein (PP), and rice protein (RP) ingredients at a 12.5% meat protein substitution level, under varying pre-hydration conditions and, subsequently, on the technological properties of hybrid plant/beef patties (HPBP). Colour measurements indicated that plant protein ingredient addition to HPBP resulted in increased lightness (L*) and decreased redness (a*) values. HPBP showed reduced cooking loss compared to 100% beef patties, and cooking loss increased with higher pre-hydration levels of plant proteins. Faba bean hybrid patty (FBHP) exhibited lower texture scores, while the patty containing non-hydrated RP had the highest hardness values. The texture of patties with PP was comparable to the control, irrespective of the hydration status of the plant protein. Inclusion of plant proteins also reduced water mobility by restricting intracellular water. Overall, these findings provide valuable insights into the selection of suitable plant proteins and the requirement for optimal pre-hydration of plant proteins prior to incorporation into HPBP to ensure optimal technological properties.

This study aims to investigate if there is a difference in the safety and efficacy of catheter ablation of atrial fibrillation (AF) between patients with bioprosthetic mitral valve replacement (MVR) and those with mechanical MVR. A total of 23,794 patients who underwent the first-time catheter ablation of AF were screened. Patients with a history of surgical AF ablation, left atrial appendage closure, or resection were excluded from the study. There were 21 patients in the bioprosthetic MVR group and 85 patients in the mechanical MVR group were included in the study. After a median follow-up of 17.9 (14.4, 21.4) months, AF recurrence rates were similar between the two groups (52.4% vs. 50.6%, log-rank p  = 0.527). Persistent AF was independently associated with AF recurrence (HR 1.83, [95% CI 1.00–3.33], p  < 0.05). Mitral isthmus block rates were 78.6% in the bioprosthetic MVR group and 69.6% in the mechanical MVR group ( p  = 0.508). No instances of catheter entrapment were reported in this study. Two pseudoaneurysm and one acute cerebral infarction occurred in the mechanical MVR group. The safety and effectiveness of AF catheter ablation were comparable between patients with mechanical MVR and those with bioprosthetic MVR.

Exaggerated orthostatic changes in systolic blood pressure (SBP) were associated with adverse cardiovascular events. We aim to assess the association between orthostatic SBP changes and incident atrial fibrillation (AF). We performed a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial). Orthostatic SBP changes were defined as standing SBP minus seated SBP. Patients were grouped into tertiles of orthostatic SBP changes. We used Cox proportional regression models to assess the association of orthostatic SBP changes with incident AF. Among 8455 participants included in this analysis, 327 incident AF cases occurred during follow‐up. After adjusting for age, female, race, smoking, alcohol use, history of cardiovascular disease, history of chronic kidney disease, and body mass index, an SBP increase ≥6 mmHg to standing was independently associated with a 43% higher risk of incident AF (HR: 1.43; 95% CI: 1.07–1.90; p = 0.014) compared to nonsignificant orthostatic SBP changes (>–4 to <6 mmHg). A SBP decrease ≥4 mmHg to standing showed a nonsignificant higher risk of developing AF compared to SBP changes of >–4 to <6 mmHg. In subgroup analysis, the results presented a similar tendency to the main result. Sensitivity analyses also generated consistent results while additionally adjusting for seated and standing blood pressure or heart rate. In this post hoc analysis of the SPRINT trial, exaggerated SBP increase on standing independently predicts incident AF. Trial Registration: ClinicalTrials.gov identifier: NCT00000620.

In order to investigate the influence of the intermediate principal stress on the stress and displacement of surrounding rock, a novel approach based on 3D Hoek-Brown (H-B) failure criterion was proposed. Taking the strain-softening characteristic of rock mass into account, the potential plastic zone is subdivided into a finite number of concentric annulus and a numerical procedure for calculating the stress and displacement of each annulus was presented. Strains were obtained based on the nonassociated and associated flow rule and 3D plastic potential function. Stresses were achieved by the stress equilibrium equation and generalized Hoek-Brown failure criterion. Using the proposed approach, we can get the solutions of the stress and displacement of the surrounding rock considering the intermediate principal stress. Moreover, the proposed approach was validated with the published results. Compared with the results based on generalized Hoek-Brown failure criterion, it is shown that the plastic radius calculated by 3D Hoek-Brown failure criterion is smaller than those solved by generalized H-B failure criterion, and the influences of dilatancy effect on the results based on the generalized H-B failure criterion are greater than those based on 3D H-B failure criterion. The displacements considering the nonassociated flow rule are smaller than those considering associated flow rules.

In this study, two types of cooling methods (vacuum cooling and air cooling) were used to cool cooked macro‐porous sausage. Alterations in the microbiological conditions, pH, instrumental color (L*, a*, and b*), total volatile nitrogenous bases (TVB‐N), lipid oxidation (TBARS), water activity (aW), moisture content, and texture indicators were evaluated to determine sausages' quality changes during storage under refrigeration for up to 10 days. In general, the shelf life of sausages chilled by vacuum cooling (8 days) was similar to that of sausages cooled by air cooling (9 days). For pH, no significant difference (p > .05) was obtained between two cooling methods. However, vacuum‐cooled sausages have lower L* value (p < .05), lower moisture content, and water activity compared with the air‐cooled sausages. However, sausages cooled by vacuum cooling showed a sharp increase in TBARS and TVB‐N values but maintained texture characteristics for a longer time compared with air‐cooled sausages. Although the results indicated that the quality of sausages treated by those two methods remarkably decreased after 7 days, characteristics of sausages cooled by vacuum cooling are better within accepted standards compared with air‐cooled sausages. In conclusion, vacuum cooling can be a feasible cooling method with great potential to be used in cooked macro‐porous sausages to maintain the quality and may provide reference experiences for the food with similar structure. Two types of cooling methods (vacuum cooling and air cooling) were used to cool cooked macro‐porous sausages, which will store almost 10 days at 4°C. Storage stability is primarily assessed by physical, chemical, and microbial parameters.

Quasi-zero-stiffness (QZS) isolator with high-static-low-dynamic stiffness can withstand heavy loads and effectively isolate vibration with low frequency. However, the ultralow frequency vibration isolation is still a challenge for the existing QZS isolators. This paper proposes an innovative design of parabolic cam-roller QZS isolators by use of nonlinear subsidiary systems to achieve ultralow dynamic stiffness and ultralow frequency vibration isolation. The theoretical formulations of the proposed QZS isolators are derived. The effects of structural parameters on stiffness characteristics are analyzed and then an optimal design are presented. The vibration isolation of the proposed QZS isolators under harmonic excitation is investigated using the averaging method, and dynamic response under impact load is studied using the Runge–Kutta algorithm. The bifurcation analysis for the designed QZS isolator is briefly presented. In comparison with the previous parabolic cam-roller QZS isolator with the linear subsidiary system and the existing QZS isolators with the nonlinear subsidiary systems, the present QZS isolators have lower stiffness in a wider displacement region, which makes them be able to isolate harmonic excitations with larger amplitude and have better isolation performance for harmonic excitations and impact loading. A prototype of the proposed QZS isolator is designed, fabricated and tested. Experimental results show that the measured force–displacement curves are in good agreement with those predicted by theory, and isolation performance of the proposed QZS isolators for vibration with ultralow frequency significantly outperforms the existing QZS isolator. Graphical abstract

We introduce a new family of dynamic mechanisms that restricts sellers from using future distributional knowledge. Since the allocation and pricing of each auction period do not depend on the type distributions of future periods, we call this family of dynamic mechanisms non-clairvoyant. We develop a framework (bank account mechanisms) for characterizing, designing, and proving lower bounds for dynamic mechanisms (clairvoyant or non-clairvoyant). We use the same methods to compare the revenue extraction power of clairvoyant and non-clairvoyant dynamic mechanisms.