Sodium alginate/guar gum based nanocomposite film incorporating β-Cyclodextrin/persimmon pectin-stabilized baobab seed oil Pickering emulsion for mushroom preservation

The poor biological, mechanical and water-resistance properties of sodium alginate/guar gum film (SG) limit its application in food preservation. To overcome this disadvantage, we added β-Cyclodextrin/persimmon pectin-stabilized baobab seed oil Pickering emulsion (BOPE) to enhance the mechanical and water resistance properties of SG film, and added green synthesized silver nanoparticles (AgNPS) and Lycium ruthenicum extract (LA) to improve the biological properties of the film. The properties of BOPE was optimized using Box-Behnken design (BBD). Scanning electron microscope and Fourier transform infrared results revealed the change of structure and molecular interaction in the SG film after the addition of AgNPS, LA, and optimized BOPE. The 2.0%BOPE-loaded film containing AgNPS/LA with the enhanced mechanical, barrier, BO retention, and biological properties not only improved the preservation effect on mushroom (A. bisporus), but also maintained structural stability. Thus, the 2.0%BOPE-loaded SG/LA/AgNPS film has considerable potential in active packaging applications.

A ratiometric fluorescence amine sensor based on carbon quantum dot-loaded electrospun polyvinylidene fluoride film for visual monitoring of food freshness

A ratiometric fluorescence sensor based on dual-emission carbon quantum dots (CQD) was developed to real time monitor food spoilage. Two hydrophobic electrospun fluorescent films were developed using polyvinylidene fluoride (PVDF) as the film-forming polymer in combination with CQD as the fluorescent probe. The CQD/PVDF film and CQD@PVDF film enabled the analysis of TMA with limits of detection (LODs) of 1.04 μM and 2.1 μM, respectively, and they exhibited excellent stability at 4 °C. By these virtues, the CQD@PVDF film exhibited visible fluorescence color changes from yellow green to blue by real time and nondestructively sensing volatile amines generated from beef, pork and shrimp in a packaging system with high humidity. This strategy provided a simple but useful, non-destructive, robust, and platform to real time monitor food spoilage for intelligent food packaging.

Transforming sustainable plant proteins into high performance lubricating microgels

With the resource-intensive meat industry accounting for over 50% of food-linked emissions, plant protein consumption is an inevitable need of the hour. Despite its significance, the key barrier to adoption of plant proteins is their astringent off-sensation, typically associated with high friction and consequently poor lubrication performance. Herein, we demonstrate that by transforming plant proteins into physically cross-linked microgels, it is possible to improve their lubricity remarkably, dependent on their volume fractions, as evidenced by combining tribology using biomimetic tongue-like surface with atomic force microscopy, dynamic light scattering, rheology and adsorption measurements. Experimental findings which are fully supported by numerical modelling reveal that these non-lipidic microgels not only decrease boundary friction by an order of magnitude as compared to native protein but also replicate the lubrication performance of a 20:80 oil/water emulsion. These plant protein microgels offer a much-needed platform to design the next-generation of healthy, palatable and sustainable foods.

A cell-based electrochemical taste sensor for detection of Hydroxy-α-sanshool

The Transient Receptor Potential Vanilloid 1 (TRPV1) has been identified as a suitable candidate for a spicy taste (Zanthoxylum plant) sensor. In this study, we investigated the response of TRPV1 expressed on human HepG2 cell membranes following stimulation with Hydroxy-α-sanshool. A three-dimensional (3D) cell-based electrochemical sensor was fabricated by layering cells expressing hTRPV1. l-cysteine/AuNFs electrodes were functionalized on indium tin oxide-coated glass (ITO) to enhance the sensor's selectivity and sensitivity. HepG2 cells were encapsulated in sodium alginate/gelatin hydrogel to create a 3D cell cultivation system, which was immobilized on the l-cysteine/AuNFs/ITO to serve as biorecognition elements. Using differential pulse voltammetry (DPV), the developed biosensor was utilized to detect Hydroxy-α-sanshool, a representative substance in Zanthoxylum bungeanum Maxim. The result obtained from DPV was linear with Hydroxy-α-sanshool concentrations ranging from 0 to 70 μmol/L, with a detection limit of 2.23 μmol/L. This biosensor provides a sensitive and novel macroscopic approach for TRPV1 detection.

Fabrication of Pickering emulsions stabilized by citrus pectin modified with β-cyclodextrin and its application in 3D printing

Pickering emulsions stabilized by polysaccharide particles have received increasing attention because of their potential applications in three-dimensional (3D) printing. In this study, the citrus pectins (citrus tachibana, shaddock, lemon, orange) modified with β-cyclodextrin (β-CD) were used to stabilize Pickering emulsions reaching the requirements of 3D printing. In terms of pectin chemical structure, the steric hindrance provided by the RG I regions was more conducive to the stability of the complex particles. The modification of pectin by β-CD provided the complexes a better double wettability (91.14 ± 0.14°-109.43 ± 0.22°) and a more negative ζ-potential, which was more beneficial for complexes to anchor at oil-water interface. In addition, the rheological properties, texture properties and stability of the emulsions were more responsive to the ratios of pectin/β-CD (R_β/C). The results showed that the emulsions stabilized at a φ = 65 % and a R_β/C = 2:2 achieved the requirements (shear thinning behavior, self-supporting ability, and stability) of 3D printing. Furthermore, the application in 3D printing demonstrated that the emulsions under the optimal condition (φ = 65 % and R_β/C = 2:2) displayed excellent printing appearance, especially for the emulsions stabilized by β-CD/LP particles. This study provides a basis for the selection of polysaccharide-based particles to prepare 3D printing inks which may be utilized in food manufacturing.

Fabrication and characterization of polyvinyl alcohol/sodium alginate/zein/ chitosan bilayer film for dynamic visualization of pork quality

The development of real-time and convenient meat freshness indication technology is crucial to ensure food safety. A novel antibacterial visualized intelligent film was designed based on polyvinyl alcohol (PA), sodium alginate (SA), zein (ZN), chitosan (CS), alizarin (AL) and vanillin (VA) using layer-by-layer assembly (LBL) method for real-time and in situ monitoring of pork freshness. The fabricated film had various advantageous properties, including an excellent hydrophobicity with a water contact angle (WCA) of 91.59°, improved color stability, excellent water barrier properties and increased mechanical performance (TS = 42.86 MPa). The fabricated film also demonstrated effective antibacterial properties with a bacteriostatic circle diameter of 13.6 mm for Escherichia coli. Moreover, the film can perceive and visualize the antibacterial effect through color changes, enabling dynamic visual monitoring of the antibacterial effect. A good correlation (R² = 0.9188) between the color changes (ΔE) and total viable count (TVC) of pork was documented. Conclusively, fabricated multifunctional film improves the accuracy and versatility of freshness indication and had great potential for food preservation and freshness monitoring. The outcomes of this research provides a new perspective for the design and development of multifunctional intelligent films.

Entrapment of probiotic (Bifidobacterium longum) in bilayer emulsion film with enhanced barrier property for improving viability

The gelatin/gellan gum based-bilayer emulsion film was developed in this work to improve the survivability of Bifidobacterium longum during the storage process. The baobab seed oil (BO) was added to the gelatin (GE) matrix to develop emulsion film as the barrier outer layer. The blueberry anthocyanin extract (BE) was incorporated into the gellan gum (GG)-based inner layer to enhance the viability of B. longum. The SEM and FTIR results revealed that the probiotics were successfully entrapped in BO/BE-loaded bilayer film. The greatest survivability and viable cell numbers of the B. longum during the storage period were observed in the BO/BE loaded bilayer film. Furthermore, the stability of the colorful patterns by electrochemical writing was also evaluated in this work. Finally, the GE/BO-GG/BE/BM maintain satisfactory probiotic viability in steamed bread coating application. Hence, the GE/BO-GG/BE/BM bilayer film could be considered a novel material to deliver and protect the probiotics in food applications.

Effect of polymer architecture on the adsorption behaviour of amphiphilic copolymers: A theoretical study

HYPOTHESIS

Polymer architecture is known to have significant impact on its adsorption behaviour. Most studies have been concerned with the more concentrated, "close to surface saturation" regime of the isotherm, where complications such as lateral interactions and crowding also additionally affect the adsorption. We compare a variety of amphiphilic polymer architectures by determining their Henry's adsorption constant (k_H), which, as with other surface active molecules, is the proportionality constant between surface coverage and bulk polymer concentration in a sufficiently dilute regime. It is speculated that not only the number of arms or branches, but also the position of adsorbing hydrophobes influence the adsorption, and that by controlling the latter the two can counteract each other.

METHODOLOGY

The Self-consistent field calculation of Scheutjens and Fleer was implemented to calculate the adsorbed amount of polymer for many different polymer architectures including linear, star and dendritic. Using the adsorption isotherms at very low bulk concentrations, we determined the value of k_H for these.

FINDINGS

It is found that the branched structures (star polymers and dendrimers) can be viewed as analogues of linear block polymers based on the location of their adsorbing units. Polymers containing consecutive trains of adsorbing hydrophobes in all cases showed higher level of adsorption compared to their counterparts, where the hydrophobes were more uniformly distributed on the chains. While increasing the number of branches (or arms for star polymers) also confirmed the known result that the adsorption decreased with the number of arms, this trend can be partially offset by the appropriate choice of the location of anchoring groups.

Novel gellan gum-based probiotic film with enhanced biological activity and probiotic viability: Application for fresh-cut apples and potatoes

A novel probiotic film based on gellan gum (GN), cranberry extract (CE), and Lactococcus lactis (LA) was developed in the present study. The fluorescence and SEM image results showed that GN/CE film containing LA was successfully fabricated. The incorporation of LA significantly enhanced the antibacterial activity of the film. The presence of CE strengthened the antioxidant activity and LA survivability in the film. The combination of LA (0-1.0 %) and CE (0.5-1.0 %) improved the mechanical property of the film through the formation of density structure. The best comprehensive properties were obtained with the film containing 2.0 %LA and 0.5 %CE. The GN/2.0 %LA/0.5 %CE film also showed the optimal preservation effect on fresh-cut potatoes and apples. Hence, GN/2.0 %LA/0.5 %CE probiotic film has proved to be suitable for fruit and vegetable preservation.

Fabrication and characterization of colorimetric indicator for Salmon freshness monitoring using agar/polyvinyl alcohol gel and anthocyanin from different plant sources

In order to investigate the sensitivity of anthocyanins from different plant origin as indicators for salmon freshness, nine plant anthocyanins were extracted and fabricated into colorimetric sensor arrays to detect NH₃, trimethylamine (TMA), dimethylamine (DMA) to indicate salmon freshness. Rosella anthocyanin had the highest sensitivity for amines, ammonia and salmon. HPLC-MSS analysis indicated that Delphinidin-3 glucoside accounted for 75.48 % of the Rosella anthocyanin. UV-visible spectral analysis showed that the maximum absorbance band of Roselle anthocyanins for acid and alkaline forms were located at 525 nm and 625 nm which showed a relatively broader spectrum than other anthocyanins. An indicator film was fabricated by combining Roselle anthocyanin with agar and polyvinyl alcohol (PVA), which showed visible changes from red to green when employed to monitor the freshness of salmon stored at 4 °C. The ΔE value of Roselle anthocyanin indicator film was changed from 5.94 to >10. The ΔE value also can predict the chemical quality indicators of salmon effectively, especially with characteristic volatile components, and the predictive correlation coefficient was above 0.98. Therefore, the proposed indicating film showed great potential monitoring salmon freshness.

Saccharomyces cerevisiae-incorporated and sucrose-rich sodium alginate film: An effective antioxidant packaging film for longan preservation

A sodium alginate (SA) film incorporated with Saccharomyces cerevisiae (SE) and sucrose (SU) was fabricated to control the quality and pericarp browning of longan. The SE with satisfactory glutathione production was selected as the antioxidant agent. The scanning electron microscopy (SEM) results revealed that the SU-rich SA film could be used as an effective carrier to protect the cell integrity of SE. The FTIR and mechanical property results indicated that the SA-SE film with the incorporation of SU has good flexibility due to the existence of hydrogen bonds. Notably, the cell viability of the SE was significantly improved with the addition of SU, which positively affects the antioxidant property of the film during the storage period. Finally, the SA-SE-3.0%SU films obviously improved the quality and pericarp browning of longan. The SA-based film incorporated with SU and SE may be established as a novel antioxidant fruit packaging material.

Increased SERCA2a sub-cellular heterogeneity in right-ventricular heart failure inhibits excitation-contraction coupling and modulates arrhythmogenic dynamics

The intracellular calcium handling system of cardiomyocytes is responsible for controlling excitation-contraction coupling (ECC) and has been linked to pro-arrhythmogenic cellular phenomena in conditions such as heart failure (HF). SERCA2a, responsible for intracellular uptake, is a primary regulator of calcium homeostasis, and remodelling of its function has been proposed as a causal factor underlying cellular and tissue dysfunction in disease. Whereas adaptations to the global (i.e. whole-cell) expression of SERCA2a have been previously investigated in the context of multiple diseases, the role of its spatial profile in the sub-cellular volume has yet to be elucidated. We present an approach to characterize the sub-cellular heterogeneity of SERCA2a and apply this approach to quantify adaptations to the length-scale of heterogeneity (the distance over which expression is correlated) associated with right-ventricular (RV)-HF. These characterizations informed simulations to predict the functional implications of this heterogeneity, and its remodelling in disease, on ECC, the dynamics of calcium-transient alternans and the emergence of spontaneous triggered activity. Image analysis reveals that RV-HF is associated with an increase in length-scale and its inter-cellular variability; simulations predict that this increase in length-scale can reduce ECC and critically modulate the vulnerability to both alternans and triggered activity. This article is part of the theme issue 'The cardiomyocyte: new revelations on the interplay between architecture and function in growth, health, and disease'.

Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study

BACKGROUND

No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge.

METHODS

The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing.

FINDINGS

2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters.

INTERPRETATION

The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials.

FUNDING

UK Research and Innovation and National Institute for Health Research.

Adolescents' dietary behaviour: The interplay between home and school food environments

In the UK, school food standards have looked to improve the nutritional profile of school food provision and the choices made; however, adolescents' choices tend to bias towards micronutrient poor and energy dense options. This study aimed to explore how adolescents make their school food choices, along with how they engage with their environments whilst selecting food. Seven focus group interviews took place with adolescents (n = 28; 13-14 years) in a secondary school in Northern England. Discussions with participants were audio-recorded, transcribed verbatim and then analysed using an inductive thematic approach. Six themes emerged from the data: (1) parents' and adolescents' roles in the home food environment, (2) burgeoning food autonomy, (3) school food choice factors, (4) social aspects of school food, (5) home versus school, (6) food knowledge & beliefs. Adolescents identified two distinct environments during the focus group discussions: the home and school environments. Adolescents juxtaposed the two, in terms of food provision, food choices, rules and customs surrounding food choice. This juxtaposition emerged as an indirect but important influence on adolescents' school food choices. The school and home environments both (in)directly influence adolescents' school food choices, which involve an integration of multiple, often conflicting influences. Adolescents may adopt a number of unhelpful dietary rationalisations as they try to manage and reconcile these influences. Consultation, together with consideration of relevant food choice models, is required to identify opportunities to influence adolescents' food choices at school.

O108 Central adiposity influences serum calcium concentrations and increases risk of kidney stone disease

Introduction

Serum calcium (SCa) and adiposity are associated with kidney stone disease (KSD). We used conventional and genetic epidemiological approaches to further understanding of these relationships.

Methods

Waist-hip ratio (WHR), a marker of central adiposity, SCa and KSD data were analysed by adjusted linear regression using UK Biobank participants. Univariable, multivariable and mediation Mendelian randomisation (MR) were undertaken using 316 and 246 genetic instruments for WHR and SCa, respectively.

Results

Observational analyses of 3,466 KSD cases and 489,944 controls showed that participants of normal BMI (20–25kg/m2) but in the fifth quintile for WHR have greater risk of incident KSD compared to the first quintile (HR=1.39 (95%CI=1.18–1.63)). After adjustment for sex, age, serum vitamin D, and phosphate, higher WHR was positively associated with SCa (ß=0.04, 95%=CI 0.04–0.05, P<0.001). Univariable MR demonstrated that relative risk of KSD increases with increasing WHR and SCa; 1 standard deviation (SD) increases relative risk by 46% (95%CI=1.27–1.67, P=5.9e-8) and 63% (95%CI=1.37–1.93, P=2.0E-8), respectively. A 1 SD increase in WHR increases SCa by 0.11mmol/L (95%CI=0.07–0.14, P=1.8e-8). Multivariable MR revealed that SCa and WHR independently increase KSD relative risk (OR=1.71, 95%CI=1.49–1.96, P<0.001 and OR=1.41, 95%CI=1.17–1.69, P<0.001 respectively). Mediation MR established that 14% of the effect of WHR on KSD risk is mediated via alterations in SCa.

Conclusion

Central adiposity is causally linked to KSD, partly by raising SCa. Mechanisms by which central adiposity increases KSD risk, independent of and via SCa, remain to be revealed and may identify novel therapeutic methods for KSD.

Take-home message

Central adiposity and serum calcium are independent, causal risk factors for kidney stone disease. One mechanism by which central obesity increases risk of kidney stone disease is by influencing serum calcium concentrations.

Individualised PatieNt Care and Treatment FOR MatErnal Diabetes (INFORMED); Intensive Profiling of Dysglycemia in Maternal Diabetes – A Longitudinal Study Protocol

Objectives

Women with pre-existing diabetes struggle to control glucose levels during pregnancy and are at high risk of pregnancy complications, compared to women without diabetes. Management of postprandial and nocturnal glucose levels are key targets to minimise risk of adverse events during pregnancy. This trial aims to investigate the effect of distinct nutrient patterns on 24-hr glucose levels in pregnant women with pre-existing diabetes to inform future strategies.

Methods

This single-blind randomised controlled trial will recruit 76 pregnant women with pre-existing Type 1 or Type 2 diabetes at ∼10–12 weeks’ gestation from the Diabetes in Pregnancy Clinics at Leeds Teaching Hospitals NHS Trust (LTHT). At three timepoints (∼10–12, ∼18–20, and ∼28–34 weeks of gestation), participants will consent to share their medical records (including general health, 7-day continuous glucose data (CGM), and obstetric information), blood and urine samples for metabolite analysis, and complete online questionnaires to assess 3-day diet and general lifestyle. Genetic analysis will also take place. Additionally, a carbohydrate challenge will take place at ∼18–20, and ∼28–34 weeks' gestation while CGM is being measured. Multiple variable analyses and clustering will be used to identify patterns and associations of interest.

Results

Ethical approval has been granted by the Tyne and Wear South Research Ethics Committee (21/NE/0196). The results will be presented at conferences and disseminated in peer-reviewed journals.

Conclusions

Findings of this study will inform the design of a feasibility trial and future interventions. Ultimately, we hope the generated data can be used to support care in women with pre-existing diabetes during pregnancy, and improve maternal and infant outcomes.

Funding Sources

University of Leeds - School of Food Science and Nutrition and Wellcome Trust.

High- sensitivity bilayer nanofiber film based on polyvinyl alcohol/sodium alginate/polyvinylidene fluoride for pork spoilage visual monitoring and preservation

A colorimetric bilayer film for pork freshness detection and preservation was developed using electrospinning technique. The bilayer film consisted of a layer with polyvinyl alcohol - sodium alginate - alizarin as sensor layer and a layer with polyvinylidene fluoride - vanillin as antibacterial layer. The water contact angle of bilayer film was larger than the single colorimetric layer. The color sensitivity to the ammonia of the bilayer film was higher, with an ΔE value of 47.99. The film could display color shifts from yellow to purple with the naked eye is critical for checking pork freshness. In addition, the bilayer film exhibited sensitive antibacterial activity, with an inhibition zone against S. aureus (8.3 mm) and E. coli (14.7 mm), respectively. Finally, the bilayer film was applied to freshness monitoring of pork. The film displayed significant color changes and prolonged the pork shelf life by 24 h at 25 °C.

Fast Burst-Sparsity Learning-Based Baseline Correction (FBSL-BC) Algorithm for Signals of Analytical Instruments

Baseline correction is a critical step for eliminating the interference of baseline drift in spectroscopic analysis. The recently proposed sparse Bayesian learning (SBL)-based method can significantly improve the baseline correction performance. However, it has at least two disadvantages: (i) it works poorly for large-scale datasets and (ii) it completely ignores the burst-sparsity structure of the sparse representation of the pure spectrum. In this paper, we present a new fast burst-sparsity learning method for baseline correction to overcome these shortcomings. The first novelty of the proposed method is to jointly adopt a down-sampling strategy and construct a multiple measurements block-sparse recovery problem with the down-sampling sequences. The down-sampling strategy can significantly reduce the dimension of the spectrum; while jointly exploiting the block sparsity among the down-sampling sequences avoids losing the information contained in the original spectrum. The second novelty of the proposed method is introducing the pattern-coupled prior into the SBL framework to characterize the inherent burst-sparsity in the sparse representation of spectrum. As illustrated in the paper, burst-sparsity commonly occurs in peak zones with more denser nonzero coefficients. Properly utilizing such burst-sparsity can further enhance the baseline correction performance. Results on both simulated and real datasets (such as FT-IR, Raman spectrum, and chromatography) verify the substantial improvement, in terms of estimation accuracy and computational complexity.

Pulse consumption improves indices of glycemic control in adults with and without type 2 diabetes: a systematic review and meta-analysis of acute and long-term randomized controlled trials

PURPOSE

Findings from randomized controlled trials (RCTs) evaluating the effect of pulse intake on glycemic control are inconsistent and conclusive evidence is lacking. The aim of this study was to systematically review the impact of pulse consumption on post-prandial and long-term glycemic control in adults with and without type 2 diabetes (T2D).

METHODS

Databases were searched for RCTs, reporting outcomes of post-prandial and long-term interventions with different pulse types on parameters of glycemic control in normoglycemic and T2D adults. Effect size (ES) was calculated using random effect model and meta-regression was conducted to assess the impact of various moderator variables such as pulse type, form, dose, and study duration on ES.

RESULTS

From 3334 RCTs identified, 65 studies were eligible for inclusion involving 2102 individuals. In acute RCTs, pulse intake significantly reduced peak post-prandial glucose concentration in participants with T2D (ES  - 2.90; 95%CI  - 4.60,  - 1.21; p ≤ 0.001; I2 = 93%) and without T2D (ES  - 1.38; 95%CI  - 1.78,  - 0.99; p ≤ 0.001; I2 = 86%). Incorporating pulse consumption into long-term eating patterns significantly attenuated fasting glucose in normoglycemic adults (ES  - 0.06; 95%CI  - 0.12, 0.00; p ≤ 0.05; I2 = 30%). Whereas, in T2D participants, pulse intake significantly lowered fasting glucose (ES  - 0.54; 95%CI  - 0.83,  - 0.24; p ≤ 0.001; I2 = 78%), glycated hemoglobin A1c (HbA1c) (ES  - 0.17; 95%CI  - 0.33, 0.00; p ≤ 0.05; I2 = 78) and homeostatic model assessment of insulin resistance (HOMA-IR) (ES  - 0.47; 95%CI  - 1.25,  - 0.31; p ≤ 0.05; I2 = 79%).

CONCLUSION

Pulse consumption significantly reduced acute post-prandial glucose concentration > 1 mmol/L in normoglycemic adults and > 2.5 mmol/L in those with T2D, and improved a range of long-term glycemic control parameters in adults with and without T2D. PROSPERO REGISTRY NUMBER: (CRD42019162322).

Short-time acoustic and hydrodynamic cavitation improves dispersibility and functionality of pectin-rich biopolymers from citrus waste

Pectin is a valuable biopolymer used as a natural, clean label additive for thickening and gelling. However, industry faces issues with dispersibility and stability of pectin formulations. To address these issues, the effect of short processing time (30-180 s) with hydrodynamic (HC) and acoustic cavitation (AC) on the dispersibility and gelling functionality of mandarin pectin-rich polysaccharide (M-PRP) was investigated. Short-time processing with HC and AC did not affect polymer composition. HC, but not AC, decreased polydispersity index (PDI) from 0.78 to 0.68 compared to the control. Electron and atomic force microscopy showed that HC and AC decreased aggregation of fibrous and matrix polymers. Both treatments increased apparent viscosity significantly from 0.059 Pa s to 0.30 Pa s at 10 ^-s. The pectin dispersions showed good gelling capacity upon addition of calcium (final conc. 35 mM). HC and AC treatments for 150 s led to gels that were 7 and 4 times stronger (as measured by peak force) than the control with more homogeneous, less porous structures. In conclusion, short-time HC and AC can improve the dispersibility and functionality of citrus pectin without affecting composition, and are promising technologies to facilitate the use of pectin in industry applications.

Estimated glucose disposal rate as a candidate biomarker for thrombotic biomarkers in T1D: a pooled analysis

PURPOSE

To determine the utility of estimated glucose disposal rate (eGDR) as a candidate biomarker for thrombotic biomarkers in patients with type 1 diabetes (T1D).

METHODS

We reanalysed baseline pretreatment data in a subset of patients with T1D from two previous RCTs, consisting of a panel of thrombotic markers, including fibrinogen, tissue factor (TF) activity, and plasminogen-activator inhibitor (PAI)-1, and TNFα, and clinical factors (age, T1D duration, HbA1c, insulin requirements, BMI, blood pressure, and eGDR). We employed univariate linear regression models to investigate associations between clinical parameters and eGDR with thrombotic biomarkers.

RESULTS

Thirty-two patients were included [mean ± SD age 31 ± 7 years, HbA1c of 58 ± 9 mmol/mol (7.5 ± 0.8%), eGDR 7.73 ± 2.61]. eGDR negatively associated with fibrinogen (P < 0.001), PAI-1 concentrations (P = 0.005), and TF activity (P = 0.020), but not TNFα levels (P = 0.881). We identified 2 clusters of patients displaying significantly different characteristics; 56% (n = 18) were categorised as 'higher-risk', eliciting significantly higher fibrinogen (+ 1514 ± 594 μg/mL; P < 0.001), TF activity (+ 59.23 ± 9.42 pmol/mL; P < 0.001), and PAI-1 (+ 8.48 ± 1.58 pmol/dL; P < 0.001), HbA1c concentrations (+ 14.20 ± 1.04 mmol/mol; P < 0.001), age (+ 7 ± 3 years; P < 0.001), duration of diabetes (15 ± 2 years; P < 0.001), BMI (+ 7.66 ± 2.61 kg/m²; P < 0.001), and lower mean eGDR (- 3.98 ± 1.07; P < 0.001).

CONCLUSIONS

Compared to BMI and insulin requirements, classical surrogates of insulin resistance, eGDR is a suitable and superior thrombotic risk indicator in T1D.

TRIAL REGISTRATION

ISRCTN4081115; registered 27 June 2017.

Effects of antibiotic treatment on antimicrobial resistance in pig microbiomes: a longitudinal study

 

The United Kingdom has prohibited the prophylactic use of antibiotics in agriculture but they are still critical for disease control. It is thus vital to understand the effects of antibiotic treatment on antimicrobial resistance (AMR) spread. Hi-C metagenomic sequencing can help identify AMR genes in animal microbiomes and assign plasmid-based genes to their bacterial hosts. Leveraging Hi-C, we sequence antibiotically-treated pig microbiomes through time to identify dynamic trends in AMR gene prevalence. Fecal samples were collected at time points prior to and following antibiotic treatment in 6 farms across England when pigs presented with illness. Control samples were collected from 2 of these farms at multiple time points without treatment. Samples were processed using a bioinformatic pipeline that outputs assemblies with information on taxonomic classification and presence/absence of an AMR allele. 115 AMR alleles across 11 antibiotic classes were included. The bacterial species in highest abundance/farm belonged to order Bacteroidales (45.9-53.1%). Tetracycline resistance alleles showed the highest prevalence/farm (28.4-52.8%). No significant association between bacterial species abundance and time point, and AMR allele prevalence and time point was found in all farms (χ2 p&gt;.05). The distribution of the number of AMR alleles/assembly was significantly higher between the first and last time point in 4/6 treated farms and 1/2 control farms (Wilcoxan rank sum p &lt;.01). A higher difference in the proportion of assemblies with greater than 6 AMR alleles between the first and last time point was observed in 1 treated farm (.17 95% CI .013-.21) compared to its control (.03 95% CI .023-.033). Slight acquisition of AMR alleles was observed but we see minimal temporal fluctuations in bacterial species abundance and AMR allele prevalence overall implying that the microbiome is fairly robust to antibiotic treatment. This encourages its responsible use for disease control.

Key messages

Ensuring that the responsible use of antibiotics does not drastically affect AMR mobilization is key to preserving the efficacy of therapeutics in agriculture. While acquisition of resistance genes over time is seen it cannot conclusively be tied to treatment; Minimal microbiome perturbation post treatment implies that therapeutic antibiotic use is warranted.

An economic evaluation of an intervention to increase demand for medical male circumcision among men aged 25-49 years in South Africa

BACKGROUND

Studies estimate that circumcising men between the ages of 20-30 years who have exhibited previous risky sexual behaviour could reduce overall HIV prevalence. Demand creation strategies for medical male circumcision (MMC) targeting men in this age group may significantly impact these prevalence rates.

OBJECTIVES

The objective of this study is to evaluate the cost-effectiveness and cost-benefit of an implementation science, pre-post study designed to increase the uptake of male circumcision for ages 25-49 at a fixed MMC clinic located in Gauteng Province, South Africa.

METHODS

A health care provider perspective was utilised to collect all costs. Costs were compared between the standard care scenario of routine outreach strategies and a full intervention strategy. Cost-effectiveness was measured as cost per mature man enrolled and cost per mature man circumcised. A cost-benefit analysis was employed by using the Bernoulli model to estimate the cases of HIV averted due to medical male circumcision (MMC), and subsequently translated to averted medical costs.

RESULTS

In the 2015 intervention, the cost of the intervention was $9445 for 722 men. The total HIV treatment costs averted due to the intervention were $542,491 from a public care model and $378,073 from a private care model. The benefit-cost ratio was 57.44 for the public care model and 40.03 for the private care model. The net savings of the intervention were $533,046 or $368,628 - depending on treatment in a public or private setting.

CONCLUSIONS

The intervention was cost-effective compared to similar MMC demand interventions and led to statistically significant cost savings per individual enrolled.

677 Quick, Simple and just as Effective – Comparing PM:L3 Ratio to NELA, P-POSSUM and NSQIP Scores for Emergency Laparotomy

Aim

Multiple tools (NELA, P-POSSUM, ACS-NSQIP) are available to assess mortality risks in patients requiring emergency laparotomy(1–3), but they are time-consuming to perform and have had limited uptake in routine clinical practice in many countries(4). Simpler measures, including psoas muscle:L3 vertebrae (PM:L3) ratio(5,6), may be useful alternates. This measure is quick to perform, requiring no special skills or equipment apart from basic CT viewing software.

Method

We performed an analysis on all patients in the Hunter Emergency Laparotomy Audit (HELA) database, from January 2016 to December 2017. HELA is a retrospective review of all emergency laparotomy undertaken in a discrete area in NSW, Australia. Patients with an available CT abdomen were included (N = 500/562). A single slice axial CT image at the L3 endplate level was analysed using ImageJ® software to measure the area of L3 and bilateral psoas muscles. This can be done using normal PACS software in routine practice.

Results

PM:L3 ratios in this cohort have a mean of 1.082 (95%CI 1.042-1.122; range 0.141-3.934). PM:L3 ratio is significantly lower (p &lt; 0.00001) in those patients who did not survive beyond 30 days (mean 0.865 [95% CI 0.746-0.984 ]) and 90 days (mean 0.888 [95%CI 0.768-1.008]) compared to patients that survived these periods (30 day mean 1.106 [95% vs. 1.033-1.179], 90 day mean 1.112 [95% CI 1.070-1.154]) . These associations are similar to those calculated by established risk assessment models.

Conclusions

PM:L3 ratio is a reliable, quick and easy risk assessment tool to identify high risk patients undergoing emergency laparotomy.

678 Can patients have their old life back? Using PM:L3 ratio to predict discharge destination of emergency laparotomy survivors

Aim

Psoas muscle:L3 vertebra (PM:L3) ratio is a relatively new risk assessment tool for emergency laparotomy(1,2) based upon the proven concept that sarcopenia – as diagnosed by low skeletal muscle index(3–6), psoas muscle density(7–9) or total psoas area(10–13) in a single axial slice CT image – correlates with increasing risks of bad outcomes in surgery. This study looks into the association between PM:L3 ratio of emergency laparotomy patients from home and their discharge destination.

Method

We performed an analysis on patients in the Hunter Emergency Laparotomy Audit (HELA) database, from January 2016 to December 2017. HELA is a retrospective review of all emergency laparotomy undertaken in a discrete area in NSW, Australia. All patients admitted from home, survived to be discharged from hospital and had an available CT abdomen were included (N = 433/562). A single slice axial CT image at the L3 endplate level was analysed using ImageJ® software to measure the area of L3 and bilateral psoas muscles.

Results

PM:L3 ratio is significantly lower in the group of patient discharged to a care facility than the group discharging back to their previous home residence (mean 0.951 vs. mean 1.128, p &lt; 0.001). Upon further analysis, the PM:L3s are divided into quartiles and stratified by sex. There is an association between lower PM:L3 and risk of discharging into a care facility (Q1 22.45%, Q2 19.59%, Q3 19.10%, Q4 5.71%).

Conclusions

PM:L3 ratio can predict the discharge destination of patients undergoing emergency laparotomy.

O20 Quick, simple and just as effective—comparing pm: L3 ratio to NELA, P-POSSUM and NSQIP scores in assessing mortality risk for emergency laparotomy

Introduction

Multiple tools (NELA, P-POSSUM, ACS-NSQIP) are available to assess mortality risks in patients requiring emergency laparotomy(1–3), but they are time-consuming to perform and have had limited uptake in routine clinical practice in many countries(4). Simpler measures, including psoas muscle: L3 vertebrae (PM: L3) ratio(5,6), may be useful alternates. This measure is quick to perform, requiring no special skills or equipment apart from basic CT viewing software.

Method

We performed an analysis on all patients in the Hunter Emergency Laparotomy Audit (HELA) database, from January 2016 to December 2017. HELA is a retrospective review of all emergency laparotomy undertaken in a discrete area in NSW, Australia. Patients with an available CT abdomen were included (N = 500/562). A single slice axial CT image at the L3 endplate level was analysed using ImageJ® software to measure the area of L3 and bilateral psoas muscles. This can be done using normal PACS software in routine practice.

Result

PM: L3 ratios in this cohort have a mean of 1.082 (95%CI 1.042–1.122; range 0.141–3.934). PM: L3 ratio is significantly lower (P &lt; 0.00001) in those patients who did not survive beyond 30 days (mean 0.865 [95% CI 0.746–0.984]) and 90 days (mean 0.888 [95%CI 0.768–1.008]) compared to patients that survived these periods (30 day mean 1.106 [95% vs. 1.033–1.179], 90 day mean 1.112 [95% CI 1.070–1.154]). These associations are similar to those calculated by established risk assessment models.

Conclusion

PM: L3 ratio is a reliable, quick and easy risk assessment tool to identify high risk patients undergoing emergency laparotomy.

Take-home Message

PM: L3 ratio is a reliable, quick and easy risk assessment tool to identify high risk patients undergoing emergency laparotomy. It is comparable to NELA, P-POSSUM and ACS-NSQIP.

Synergistic Interactions of Plant Protein Microgels and Cellulose Nanocrystals at the Interface and Their Inhibition of the Gastric Digestion of Pickering Emulsions

It is possible that Pickering emulsions can optimize the transport of nutraceuticals, pharmaceuticals, and other bioactive compounds in human physiology. So-called ultrastable Pickering emulsions are often destabilized in the gastric digestion regime if the particles are proteinaceous in nature. The present study seeks to test how the interfacial structure can be engineered via synergistic particle-particle interactions to impact the gastric coalescence of Pickering emulsions. In this study, we designed plant-based protein-particle-stabilized oil-in-water emulsions (PPM-E, with 20 wt % sunflower oil) via pea protein microgels (PPM at 1 wt %). The PPM hydrodynamic diameter is ∼250 nm. In vitro gastric digestion of PPM-E confirmed droplet coalescence within 30 min of pepsin addition. Supposedly surface-active cellulose nanocrystals (CNCs, 1-3 wt %) were added to PPM-E at pH 3.0 to determine if they could act as a barrier to interfacial pepsinolysis due to the CNC and PPM being oppositely charged at this gastric pH value. A combination of confocal microscopy, zeta potential, and Langmuir trough measurements suggested that CNCs and PPMs might form a combined layer at the O/W interface, owing to the electrostatic attraction between them. CNCs at >2 wt % inhibited the pepsinolyis of the adsorbed PPM film and thus droplet coalescence. However, increasing concentrations of CNC also increased the bulk viscosity of the PPM-E and eventually caused gelation of the emulsions, which would also delay their gastric breakdown. In conclusion, tuning the bulk and interfacial structure of Pickering emulsions via synergistic interactions between two types of particles could be an effective strategy to modify the enzymatic breakdown of such emulsions, which would have important applications in pharmaceuticals, foods, and other soft-matter applications.

Review on fat replacement using protein-based microparticulated powders or microgels: A textural perspective

Background

Due to the growing rise in obesity and food-linked diseases, the replacement of calorie-dense fat has been a key focus of food industries in the last few decades with proteins being identified as promising fat replacers (FRs).

Scope and approach

This review aims to provide an overview of animal and plant protein-based FR studies that have been performed in the last 5 years. Protein isolates/concentrates, their microparticulated forms and protein microgels in model and real foods have been examined. Special emphasis has been given on the characterisation techniques that have been used to compare the full fat (FF) and low fat (LF) versions of the foods using FRs.

Key findings and conclusions

Microparticulated whey protein (MWP) has been the preferred choice FR with some success in replacing fat in model foods and dairy applications. Plant proteins on the other hand have attracted limited research attention as FRs, but show success similar to that of animal proteins. Key characterisation techniques used to compare full fat with low fat products containing FRs have been apparent viscosity, texture profile analysis, microscopy, particle size and sensory properties with oral tribology being a relatively recent undertaking. Coupling tribology with adsorption techniques (muco-adhesion) can be effective to bridge the instrumental-sensory property gap and might accelerate the development cycle of designing low/no fat products. From a formulation viewpoint, sub-micron sized microgels that show shear-thinning behaviour and have boundary lubrication properties offer promises with respect to exploiting their fat replacement potential in the future.

Retention and stability of bioactive compounds in functional peach beverage using pasteurization, microwave and ultrasound technologies

The peach functional beverages pasteurized for 10 min at 90 °C, microwaved for 1.5 min at 850 W of power and sonicated for 90 min at 20 kHz of frequency were selected to keep in storage for up to 30 days in refrigerator to examine the changes happened to their physicochemical characteristics and functional components. It was observed that the pH and the cloud values of all processed juice samples reduces with the storage time, whereas, the total soluble solids almost remain consistent particularly in microwave and ultrasound treated samples. While storage period causes the decrement in total phenolic content (TPC) and total flavonoid content of treated beverage samples, but ultrasound processing showed greater retention of TPC value up to 5.7% more than other techniques during storage. The similar trend was observed for antioxidant activity where the ultrasound treatment showed improved free radicals (2,2-diphenyl-1-picrylhydrazyl and 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) scavenging activities except ferric ion reducing antioxidant power after 30 days of storage.

Availability and Nutritional Content of High Energy and High Protein Milk for Malnourished Older Adults

Objectives

Malnutrition in older adults reduces quality of life and is increasing in prevalence in many countries. Fortified milk (milk powder added to whole milk), typically forms part of guidelines globally for adults at risk of malnutrition. Protein-enriched fresh milk (PEM) may be a simpler option as it is ready to use. This study aims to investigate the availability and nutritional content of fortified milk and PEM.

Methods

The 7 largest supermarket chains (by UK market share) were surveyed in-store and online in a large city over 2 weeks in December 2019. Two were discount retailers and 3 did not offer online shopping. For each chain, a large, mid-size and convenience store type were randomly selected, if present within the city. In total 15 stores were visited (5 large, 7 mid-size and 3 convenience). Price and nutritional information were recorded on a pro forma for all milk powders and PEMs in-store and online. The energy & protein content of a 200 ml portion of fortified milk (made as per guidelines with milk powders found) and cost/g of protein was considered and compared with PEM and standard whole milk.

Results

Six brands of skimmed milk powder (SMP), 1 brand of whole milk powder (WMP) and 3 brands of PEM were found. SMP was the most available (5 large & 5 mid-sized stores), followed by PEM (2 large and 1 mid-sized store), whilst WMP was only found online. The 3 convenience stores and 2 discount retailers did not stock any milk powders or PEM.

Energy in 200 ml portions ranged from 90 – 224 kcals and protein from 8.0 – 14.2 g. Fortified milk made with SMP had the highest protein content (Mdn = 13.8 g, IQR = 13.5 – 14.2 g), double that of standard whole milk. Fortified milk made with WMP had the highest energy content (224 kcals) but less protein than fortified milk made with SMP (12.0 g). PEM had the lowest energy (Mdn = 96 kcals, IQR = 90 – 98 kcals) and lowest protein content (Mdn = 9.4 g, IQR = 8.0 – 10.0 g). Cost/g of protein was highest for fortified milk made with WMP (Mdn = 2.5p, IQR = 2.3 – 2.7p), followed by PEM (Mdn = 2.0p, IQR = 1.9 – 2.5p) and lowest for fortified milk made with SMP (Mdn = 1.8p, IQR = 1.8 – 2.2p).

Conclusions

Based on nutritional content, availability and price, the preferred option found was fortified milk made with SMP; enriched fresh milks did not compare favourably for any of these criteria. Convenience and discount stores had poor availability of the products surveyed.

Funding Sources

Self-funded.

“I Control What I Eat and I'm Sensible with What I Eat, Apart from School” – A Qualitative Study of Adolescents’ Food Choices and the School Environment

Objectives

Adolescent obesity is a significant issue in the UK, with 36% of 11 to 15 year olds classified as overweight or obese. Schools are seen as a sound setting to address this phenomenon. Mandatory School Food Standards have endeavoured to improve the nutritional profile of school food provision. However students often choose micronutrient poor, energy dense options. This study aimed to explore how and why secondary school students make their food choices within the school environment.

Methods

Seven focus group interviews were conducted with students (n = 28) aged 13–14 years in a school in Northern England. Development of the focus group schedule was informed by the socio-ecological model and food choice process model. Question topics included school food provision, students’ food choices and the role of friends and family in students’ food choices. Discussions were audio-recorded, transcribed verbatim and analysed using an inductive thematic approach: an iterative process of reading and re-reading transcripts, coding of nodes and grouping of nodes into unique themes. NVivo12 software was used to facilitate data management.

Results

Six initial themes emerged; (1) home environment, (2) food knowledge, (3) food choice factors, (4) food autonomy struggle, (5) social influences and (6) home versus school. Findings suggest that adolescents juxtapose the school and home food environments, in terms of food provision, food choices, as well as food-related rules and customs. Students identified food choices at home as being a structured and clearly defined process, with parents and caregivers acting as nutritional gatekeepers. In contrast, students depicted school food choices as being less straight-forward, determined by factors including social influences and school food choice parameters (e.g., time, queues, cost). Students reported choosing less “healthy” items at school than at home, and justified this by reportedly adopting perceived healthier choices/behaviours at home.

Conclusions

Both the school and home environment (in)directly influence adolescents’ school food choices. Further research is needed to understand these contrasting environmental influences, and how adolescents manage and integrate their food choice behaviours in different environments.

Funding Sources

Research funded by the University of Leeds.

Functional quality of optimized peach-based beverage developed by application of ultrasonic processing

The influence of thermal treatment (at 90°C for 10 min) and sonication (at 20 kHz and 130 W for 30, 60, and 90 min on room temperature) on the physicochemical properties, bioactive compounds, antioxidant activity, and organic acids of fresh formulated functional peach beverage was investigated. The results indicated that conventional pasteurization and sonication treatment did not show any significant changes in pH value and Brix amount of juice, and however, a rise in cloud value was observed under all processing conditions. The thermal treatment caused the decrement in total phenolic content (TPC), total flavonoid content (TFC), antioxidant activity (assessed by diphenyl dipicryl hydrazyl (DPPH), ferric ion reducing antioxidant power (FRAP) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS)), and organic acids of juice, whereas sonication treatment for 90 min increased maximum the activity of bioactive compounds (TPC: 600.61 µg/100 ml; TFC: 177 µg CE/100 ml), antioxidants (DPPH: 51.87%; FRAP: 506.13 µmol Trolox/L; ABTS: 1,507.375 µmol Trolox/L), and organic acids (malic acid: 998; citric acid: 128; oxalic acid: 145; shikimic acid: 63 µg/100 ml) as compared to other treatment conditions and control. Multivariate data analysis was done by principal component analysis as it identifies patterns in data by comparing data sets which is further expressed based on their similarities and discriminations, respectively.

A Dietary Intervention of Bioactive Enriched Foods Aimed at Adults at Risk of Metabolic Syndrome: Protocol and Results from PATHWAY-27 Pilot Study

Around a quarter of the global adult population have metabolic syndrome (MetS) and therefore increased risk of cardiovascular mortality and diabetes. Docosahexaenoic acid, oat beta-glucan and grape anthocyanins have been shown to be effective in reducing MetS risk factors when administered as isolated compounds, but their effect when administered as bioactive-enriched foods has not been evaluated.

OBJECTIVE

The overall aim of the PATHWAY-27 project was to evaluate the effectiveness of bioactive-enriched food consumption on improving risk factors of MetS. A pilot study was conducted to assess which of five bioactive combinations provided within three different food matrices (bakery, dairy or egg) were the most effective in adult volunteers. The trial also evaluated the feasibility of production, consumer acceptability and gastrointestinal tolerance of the bioactive-enriched food.

METHOD

The study included three monocentric, parallel-arm, double-blind, randomised, dietary intervention trials without a placebo. Each recruiting centre tested the five bioactive combinations within a single food matrix.

RESULTS

The study was completed by 167 participants (74 male, 93 female). The results indicated that specific bioactive/matrix combinations have effects on serum triglyceride or HDL-cholesterol level without adverse effects.

CONCLUSION

The study evidenced that bioactive-enriched food offers a promising food-based strategy for MetS prevention, and highlighted the importance of conducting pilot studies.