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The objective of this study was to perform prediction in silico of bioactivity, toxicity, allergenicity, and cell penetration potentials and evaluate, in vitro, the biological activities of swine plasma hydrolysates obtained using pepsin. The size of the peptides was determined through SDS-PAGE electrophoresis and the presence of functional groups through Fourier transform infrared spectroscopy (FTIR). Proteins and peptides were separated by online nanoscale capillary liquid chromatography and analyzed by tandem mass spectrometry with nanoelectrospray (nanoESI MS/MS). In silico potentials were obtained using digital platforms. Antioxidant activity, inhibition of α-amylase and α-glucosidase digestive enzymes, and inhibition of angiotensin-I converting enzyme were determined in vitro. The maximum degree of hydrolysis (28.44%) was obtained at 42 °C, pH 2, and 125 rpm. Peptides with sizes inferior to 10 kDa were obtained, and the FTIR spectra showed the efficiency of the enzyme. A total of 129 proteins and 376 peptides were identified, of which 72 presented bioactive potential. No bioactive peptide presented toxicity potential. However, 79.17% are possible allergens. Six bioactive peptides are cellular penetrants. The need for further in vitro evaluation is evident. The antioxidant activity values were considered satisfactory, with DPPH radical scavenging and iron-reducing power, more than 80%. All hydrolysates tested inhibited α-amylase and α-glucosidase, however, a low inhibition. The maximum inhibition of the angiotensin-converting enzyme was 15.41%. For these enzymes, the values of inhibition can be increased with the purification of peptides that have bioactivity, identified in the in silico study. Swine plasma can be a protein source with the potential to provide compounds with biological activities for functional/nutraceutical application. [ABSTRACT FROM AUTHOR]

The article deals with the obligation of hospitals to determine fees imposed on patients in acquired physician practices and other hospital-based facilities in the U.S. and in Connecticut. Topics discussed include the legal basis for patient notification of hospital facility fee charges, the definition of a facility fee and the requirements of written notice to patients regarding these fees. The role of staff of physician practices in explaining the process involved in fees is also discussed.

Objective: Compare clinical outcomes and costs in a study group of long-term acute care hospital (LTCH) patients with a control group of LTCH-eligible patients in an acute care hospital. LTCHs were created to provide post-acute care services not available at other post-acute settings. This is based on the premise that these patients would otherwise have stayed at acute care hospitals as high-cost outliers. The LTCH hospital is intended to deliver care to patients more efficiently, however, there are little documented clinical and financial data regarding the comparative clinical outcomes and costs for patients., Methods: Retrospective medical and billing record review of patients from the following groups: (1) LTCH study comprising patients admitted directly from an acute care hospital to the study LTCH and discharged from the LTCH from September 2004 through August 2006; (2) a control group of LTCH-eligible, medically complex patients treated and discharged from an acute care hospital in FY 2002. The control group was selected from approximately 500 patients who had at least one of the ten most common principle diagnosis DRGs of the study LTCH with >30-day length of stay at the referring hospital and met NALTH admitting guidelines., Results: Discharge disposition is an important outcome measure of the quality of care of medically complex patients. The in-hospital mortality rate trended lower and home discharge was 3 times higher for the LTCH study group than for the control group. As a possible result, SNF discharge of LTCH patients was approximately half that of the control group. Both mean patient cost per day and mean total cost per patient were significantly higher in the control group than in the LTCH study group., Conclusions: The patients in the LTCH study group had both better clinical outcomes and lower cost of care than the control group.