Nanotechnology-based optical sensors for Baijiu quality and safety control

Baijiu quality and safety have received considerable attention owing to the gradual increase in its consumption. However, owing to the unique and complex process of Baijiu production, issues leading to quality and safety concerns may occur during the manufacturing process. Therefore, establishing appropriate analytical methods is necessary for Baijiu quality assurance and process control. Nanomaterial (NM)-based optical sensing techniques have garnered widespread interest because of their unique advantages. However, comprehensive studies on nano-optical sensing technology for quality and safety control of Baijiu are lacking. In this review, we systematically summarize NM-based optical sensor applications for the accurate detection and quantification of analytes closely related to Baijiu quality and safety. Furthermore, we evaluate the sensing mechanisms for each application. Finally, we discuss the challenges nanotechnology poses for Baijiu analysis and future trends. Overall, nanotechnological approaches provide a potentially useful alternative for simplifying Baijiu analysis and improving final product quality and safety.

Inoculation fermentation with Lactobacillus fermentum L28 and Staphylococcus epidermidis S24 for improving the protein degradation of air-dried goose

The inoculation fermentation technology was applied to the processing of dried cured goose to investigate the protein degradation. Lactobacillus fermentum (L), Staphylococcus epidermidis (S) and mixed strains (L + S) were individually inoculated into the whole goose before drying. We studied the degradation of protein in the air-dried period of goose. The results showed that compared with natural fermentation, inoculation fermentation significantly increased the content of non-protein nitrogen (14.85 mg/g NPN), proteolysis index (8.98% PI), myofibril fragmentation index (89.35 MFI) and total amount of free amino acids (1332.6 mg/g FAA) of dried cured goose. Electrophoresis revealed that the inoculation fermentation accelerated the degradation of macromolecular proteins and the accumulation of small molecular proteins. The degree of protein degradation in four groups of goose was in an order of L + S group > S group > L group > CK group. It suggested that inoculation fermentation could promote the degradation of myofibrillar proteins.

Exogenous chlorogenic acid inhibits quality deterioration in fresh-cut potato slices

Fresh-cut potatoes are prone to surface browning and physiological degradation. Chlorogenic acid (CGA), a natural phenolic antioxidant, has demonstrated preservative properties in various postharvest products. However, the underlying mechanisms of its application on maintaining quality remain unclear. Therefore, the effect of exogenous CGA treatment on quality deterioration of potato slices and the mechanisms involved were investigated. Results revealed CGA treatment retarded the browning coloration, suppressed microbial growth and inhibited the declines in starch, and ascorbic acid contents in potato slices. Meanwhile, the treatment activated the phenylpropanoid pathway but decreased the activities of phenolic decomposition-related enzymes such as polyphenol oxidase (PPO) and tyrosinase and downregulated StPPO expression. Moreover, the treated slices exhibited reduced accumulation of reactive oxygen species and increased activity of antioxidant enzymes. Additionally, they displayed enhanced 2,2-diphenyl-1-picrylhydrazyl radicals scavenging capacity and higher ATP levels. Therefore, these findings indicated that CGA treatment was effective for quality maintenance and antioxidant capacity enhancement in fresh-cut potatoes, thereby providing potential strategies for the preservation and processing of fresh-cut produce.

Effect of magnetic nano-particles combined with multi-frequency ultrasound-assisted thawing on the quality and myofibrillar protein-related properties of salmon (Salmo salar)

Multi-frequency ultrasound-assisted thawing (MUAT) has been proven to be an effective method of maintaining the quality of frozen food. The effects of magnetic nano-particles (MNPs) combined with MUAT and multi-frequency ultrasound-assisted sequential thawing (MUST) on water retention, myofibrillar protein (MP) structural characteristics, function characteristics, and MP aggregation and degradation of salmon (Salmo salar) were studied. The results showed that MNPs combined with multi-frequency ultrasound-assisted sequential thawing (MNPs-MUST) significantly improved the thawing rate and the retention of water and had better emulsifying and foaming properties. MNPs-MUST treatment reduced the oxidation and degradation of MP, increased sulfhydryl content, and protected the structure of MP. Confocal laser scanning microscopy (CLSM) indicated that the MP transformed into a filamentous polymer into more evenly distributed units, resulting in higher protein solubility, lower surface hydrophobicity, and lower protein turbidity. Therefore, MNPs combined with MUST has a potential application value in the thawing research of frozen salmon.

Preservation effects of photodynamic inactivation-mediated antibacterial film on storage quality of salmon fillets: Insights into protein quality

The preservation effects of a photodynamic inactivation (PDI)-mediated polylactic acid/5-aminolevulinic acid (PLA/ALA) film on the storage quality of salmon fillets were investigated. Results showed that the PDI-mediated PLA/ALA film could continuously generate reactive oxygen species by consuming oxygen to inactivate native pathogens and spoilage bacteria on salmon fillets. Meanwhile, the film maintained the content of muscle proteins and their secondary and tertiary structures, as well as the integrity of myosin by keeping the activity of Ca2+-ATPase, all of which protected the muscle proteins from degradation. Furthermore, the film retained the activity of total superoxide dismutase (T-SOD), suppressed the accumulation of lipid peroxides (e.g., MDA), which greatly inhibited four main types of protein oxidations. As a result, the content of flavor amino acids and essential amino acids in salmon fillets was preserved. Therefore, the PDI-mediated antimicrobial packaging film greatly preserves the storage quality of aquatic products by preserving the protein quality.

Glutamate application maintains quality and antioxidant capacity of fresh-cut carrots by modulating GABA shunt, phenylpropanoid and ROS metabolism

The effects of exogenous glutamate treatment on the quality attributes, γ-aminobutyric acid (GABA) shunt, phenylpropanoid pathway, and antioxidant capacity of fresh-cut carrots were investigated. Results showed that glutamate treatment suppressed the increases in lightness and whiteness values, inhibited the degradation of total carotenoids and maintained better flavor and taste in fresh-cut carrots. Moreover, glutamate treatment rapidly promoted the activities of glutamate decarboxylase and GABA transaminase, thus improving the GABA content. It also significantly enhanced the activities of phenylalanine ammonia-lyase, cinnamate-4-hydroxylase, and 4-coumarate coenzyme A ligase and promoted the accumulation of total phenolics as well as the main individual phenolic compounds, including chlorogenic and caffeic acid. In addition, glutamate application activated the reactive oxygen system-related enzyme including peroxidase, superoxide dismutase, ascorbate peroxidase, and catalase activities to maintain higher antioxidant capacity in fresh-cut carrots. These results demonstrated that exogenous glutamate treatment maintained better nutritional quality and alleviated color deterioration by accelerating the accumulation of GABA and phenolics and enhancing the antioxidant capacity in fresh-cut carrots.

Restructuring plant-derived composites towards the production of meat-analog based coated fried food

This study utilized different plant-based composites to develop restructured meat-analog (MA). Physicochemical, thermal, mechanical, structural, and sensory properties of formulated MA as well as batter-coated fried MAs were studied, and compared with a commercial product. Protein (23.27-24.68 %), moisture (57.05-58.78 %), pH (7.19-7.57), color (L:64.76-66.84, a:0.62-1.98, b:18.84-20.49), and textural (MF:0.22-0.52 N, GF:0.07-0.24 N/sec, FA:0.74-1.92 N.sec) attributes of formulated MAs were substantially impacted by the ratio of soy-protein-isolate (SPI) and wheat-gluten (WG). Incorporation of higher WG and lower SPI resulted in the formation of chicken-like fibrous and porous structure, hence, increased consumers acceptability of MA-based coated fried products. Microporosity (crust:51.14-58.35 %, core: 63.57-71.55 %), surface opening (5.67-14.75 %), and fractal dimension (2.586-2.402) of coated fried MAs were dependent on the formulation of batter-coating. MA-based coated fried products surface moisture-fat (SMR:0.51-187.20 au; SFR: 2.01-20.17 au) profile significantly (p < 0.05) varied with the formulations of batter-coating. Negative glass-transition-temperature (around -23 °C) is prime concern for MA-based fried products stability at room environment.

Quality assessment of health science-related short videos on TikTok: A scoping review

OBJECTIVE

The aims of this review are to clarify the current state of research in terms of assessment tools and assessors of the quality of health science-related short videos on TikTok, to identify limitations in existing research; and to provide a reference for future studies.

METHODS

A scoping review was conducted. The Cochrane Library, PubMed, MEDLINE, Web of Science, Embase, Scopus, EBSCO, CNKI, VIP, Wanfang Data, and CBM databases were searched from September 2016 to November 2022. Manual searching was also performed to identify additional eligible studies. A total of 2620 documents were initially retrieved, and 29 were ultimately included. The literature was screened and collected, and data were extracted and summarized by 2 researchers.

RESULTS

(1) The quality evaluation tools used in the 29 papers included the DISCERN, PEMAT(A/V), GQS, JAMA, HONcode, guidelines and self-developed tools. Twenty-four of the included articles used the DISCERN for quality assessment, which was the most frequently used evaluation tool. However, most of these tools were not developed to assess health science-related short videos, lacked credibility tests, and had poor applicability; therefore, the accuracy of the evaluation results might be biased. (2) The assessors of the quality of health science-related short videos on TikTok were mainly experts in related fields and medical students, with doctors (12/14) being the most common evaluators. Fifteen studies did not report the identity of the evaluators, and 12 studies did not report interrater reliability.

CONCLUSION

This scoping review found that there is a lack of specific quality assessment tools for health science-related short videos on TikTok. Second, the current quality assessors of health science-related short videos on TikTok are limited. Future research should focus on the development of reliable, scientific quality assessment tools for health science-related short videos; unifying the evaluation standards; inviting users with different backgrounds and different health literacy levels to conduct quality assessments; exploring the quality assessment of health science-related short videos on TikTok from different perspectives.

Application of sodium alginate-based edible coating with citric acid to improve the safety and quality of fresh-cut melon (Cucumis melo L.) during cold storage

The safety and quality of fresh-cut melons is reduced by a series of decay processes by enzymatic browning and microbial contamination. This study aimed to assess the impact of a 2% sodium alginate-based edible coating (ALC) combined with different concentrations of citric acid (CA; 0.5%, 1%, 2%, and 3%) on the microbial safety and physical quality of fresh-cut melons during a 7-day storage period at 10 °C. The findings revealed that the combination of ALC and 3% CA was successful in preventing the growth of pathogenic bacteria (Escherichia coli O157:H7, Salmonella spp., Listeria monocytogenes, and Staphylococcus aureus) and natural microflora on fresh-cut melons during storage. In addition, treating fresh-cut melons with ALC containing 3% CA improved their quality by reducing browning and softening during storage at 10 °C. Based on these findings, it can be concluded that using ALC with 3% CA is an effective method to improve the safety and quality of fresh-cut melons.

The influence of γ-PGA on the quality of cooked frozen crayfish during temperature fluctuations

The purpose of this study was to compare the influences of gamma-poly glutamic acid (γ-PGA) (1, 2, 3, and 4 %) to see which could outperform conventional cryoprotectant mixture (4 % sorbitol + 4 % sucrose) on cooked crayfish properties, such as physicochemical, textural qualities, oxidation reaction, water distributions, and microstructure integrity, during different freeze-thaw cycles. Crayfish quality characteristics improved significantly as γ-PGA concentration increased compared to control samples.Adding γ-PGA 4 % reduced the carbonyl content from 4.20 to 3.00 nmol/ mg protein during fluctuation-1 (F1), and from 4.15 to 2.80 nmol/ mg protein during fluctuation-2 (F2) compared to control samples. Furthermore, it increased the total sulfhydryl content from 4.15 and 4.76 to 6.19 and 6.47 mol/105 g protein during F1 and F2 and after five freeze-thaw cycles (FTC). This suggests that this concentration was more effective at controlling protein changes than other concentrations. γ-PGA generally enhanced the water-holding capacity by preventing protein denaturation and limiting ice crystal recrystallization. As a result, microstructure stability was evident, texture degradation was avoided, and the crayfish's color was preserved.

Modified chitosan with different phenolic acids: Characterization, physicochemical properties, and biological activity

This study synthesized five phenolic acid-chitosan copolymers utilizing the carbodiimide-mediated chemical crosslinking reaction. Comprehensive evaluations were conducted on their structural attributes, physicochemical properties, and biological activities. Fourier transform infrared confirmed successful grafting of phenolic acids onto chitosan via amide linkages. Additionally, ultraviolet-visible absorption spectroscopy and proton nuclear magnetic resonance analyses revealed novel absorption peaks between 200 and 400 nm and 6.0-8.0 ppm, respectively, attributable to the incorporated phenolic acids. Notably, the chitosan-gentisate acid copolymer exhibited significantly enhanced biological activity (p < 0.05) compared to pure chitosan and the other four conjugates, attributed to its highest grafting degree of approximately 295.93 mg/g. These modified chitosan derivatives effectively preserved the quality of sea bass (Lateolabrax japonicus) during refrigerated storage, extending its shelf-life by up to 9 days, 7 days, and 4 days relative to control, chitosan, and gentisate acid groups.

Quality characteristics of cereal-based foods enriched with different degree of polymerization inulin: A review

Vegetables, cereals and fruit are foods rich in fibre with beneficial and nutritional effects as their consumption reduces the onset of degenerative diseases, especially cardiovascular ones. Among fibres, inulin, oligofructose or fructooligosaccharide (FOS) are the best-studied. Inulin is a generic term to cover all linear β(2-1) fructans, with a variable degree of polymerization. In this review a better understanding of the importance of the degree of polymerization of inulin as a dietary fibre, functions, health benefits, classifications, types and its applications in the food industry was considered in different fortified foods. Inulin has been used to increase the nutritional and healthy properties of the product as a sweetener and as a substitute for fats and carbohydrates, improving the nutritional value and decreasing the glycemic index, with the advantage of not compromising taste and consistency of the product. Bifidogenic and prebiotic effects of inulin have been well established, inulin-type fructans are fermented by the colon to produce short-chain fatty acids, with important local and systemic actions. Addition of inulin with different degrees of polymerization to daily foods for the production of fortified pasta and bread was reviewed, and the impact on sensorial, technological and organoleptic characteristics even of gluten-free bread was also reported.

Lingtou Dancong) leaf quality under different nitrogen fertilization regimes

Our study investigated the impact of nitrogen fertilization at 0, 150, 300, and 450 kg/ha on the non-volatile and volatile substances, as well as gene expression in fresh leaves from Lingtou tea plants. We found that applying nitrogen at 450 kg/ha notably increased total polyphenols (TPs) and free amino acids (AAs) while decreasing the TP to AA ratio (TP/AA) and total catechins (TC) contents. Chlorophyll, caffeine (CAF) and theanine accumulated to a greater extent with nitrogen application rates of 150, 300, and 450 kg/ha, respectively, six substances - TP, CAF, TC, theanine, epigallocatechin (EGC), and AA - as key contributors to the taste quality of LTDC. Additionally, five substances with variable importance in projections (VIP) ≥ 1 and odor activation values (OAV) ≥ 1, notably linalool and cis-linalool oxide (furanoid), significantly contributed to the tea's overall aroma. Furthermore, applying 300 kg/ha nitrogen upregulated the dihydroflavonol reductase (DFR)gene, likely causing catechin decrease.

Translating a Culture of Quality to Clinical Research Conduct: Expanding the Clinical Development Quality Framework

The International Council on Harmonisation E8 Guidance Revision 1 (ICH E8(R1)) calls for creating a Culture of Quality that "values and rewards critical thinking and open, proactive dialogue about what is critical to quality." Across the biopharma landscape, clinical sites, sponsors, and service providers are working to translate this far-reaching guideline into working practices. This manuscript deconstructs key elements that comprise the critical thinking and open, proactive Culture of Quality "enablers." In addition, maturity models are provided so readers can visualize what a Culture of Quality looks like in their clinical research organization. These provide examples of high performing cultures of quality and useful tools for teams or organizations to measure and evolve their respective quality cultures.

Examining concept development classroom interaction quality and children's developmental progress in state pre-K/head start programs using pre-K CLASS and LAP-3

Concept Development [CD] in the early years cannot be complete without teachers' support. However, limited research exists. This research aimed to assess CD classroom interactional quality and its relationship with other quality dimensions/domains and children's overall development using the data collected in State Pre-K/Head Start classrooms with Pre-K CLASS and LAP-3. Data collected from 171 classrooms underwent analysis with Python and SPSS. Pre-K CLASS scores showed that with the exception of one high-quality classroom, all other classrooms were categorized as either mid-quality or low-quality CD. Moreover, most teachers showed lower interactional quality not only in the CD dimension but also in the Quality of Feedback [QF] and Language Modeling [LM] dimensions of Instructional Support [IS], than in the dimensions of Emotional Support [ES] and Classroom Organization [CO] domains. The results indicated that CD, QF, and LM quality dimensions did not differ across the classrooms or districts. However, ES, CO, and IS domains differed significantly. While the observed differences for ES and CO were similar between the two districts, District 1 had higher mean IS scores than District 2. Furthermore, LAP-3 scores of 2514 children showed that 26.7 % of children scored below the expected level in cognitive development and 35.5 % scored below in language development by the end of the school year, with a higher proportion of male children falling in this category. Nonetheless, children attending State Pre-K/Head Start classrooms demonstrated an average gain of 4 months beyond their chronological age. The multi-level regression analysis of Pre-K CLASS and those LAP-3 scores showed no statistically significant relationship between interactional quality and children's developmental progress. Children in mid-quality CD classrooms showed slightly more progress in all areas of development, except in personal/social, compared to children in low-quality CD classrooms. Similarly, children in mid-quality IS classrooms outperformed those in low-quality IS classrooms in all LAP-3 areas except personal/social and pre-writing as well. In conclusion, the current research suggests that many teachers struggle not only to effectively provide high-quality CD teacher-child interactions but also high-quality IS teacher-child interactions in their classrooms. Comprehensive in-service training on CD and an alternative assessment tool that extends beyond the 72-month age limit are strongly recommended. This is important to ensure that teachers are equipped with the necessary skills and motivation to provide high-quality education to young children to prevent developmental delays in children.

Disentangling the impact of alternative payment models and associated service delivery models on quality of chronic care: A scoping review

Payment reforms are frequently implemented alongside service delivery reforms, thus rendering it difficult to disentangle their impact. This scoping review aims to link alternative payment arrangements within their context of service delivery, to assess their impact on quality of chronic care, and to disentangle, where possible, the impact of payment reforms from changes to service delivery. A search of literature published between 2013 and 2022 resulted in 34 relevant articles across five types of payment models: capitation/global budget (n = 13), pay-for-coordination (n = 10), shared savings/shared risk (n = 6), blended capitation (n = 3), and bundled payments (n = 1). The certainty of evidence was generally low due to biases associated with voluntary participation in reforms. This scoping review finds that population-based payment reforms are better suited for collaborative, person-centred approaches of service delivery spanning settings and providers, but also highlights the need for a wider evidence base of studies disentangling the impact of financing from service delivery reforms. Limited evidence disentangling the two suggests that transforming service delivery to a team-based model of care alongside a purchasing reform shifting to blended capitation was more impactful in improving quality of chronic care, than the individual components of payment and service delivery. Further comparative studies employing causal inference methods, accounting for biases and quantifying aspects of service delivery, are needed to better disentangle the mechanisms impacting quality of care.

Vegetable oils: Classification, quality analysis, nutritional value and lipidomics applications

Lipids are widespread in nature and play a pivotal role as a source of energy and nutrition for the human body. Vegetable oils (VOs) constitute a significant category in the food industry, containing various lipid components that have garnered attention for being natural, environmentally friendly and health-promoting. The review presented the classification of raw materials (RMs) from oil crops and quality analysis techniques of VOs, with the aim of improving comprehension and facilitating in-depth research of VOs. Brief descriptions were provided for four categories of VOs, and quality analysis techniques for both RMs and VOs were generalized. Furthermore, this study discussed the applications of lipidomics technology in component analysis, processing and utilization, quality determination, as well as nutritional function assessment of VOs. Through reviewing RMs and quality analysis techniques of VOs, this study aims to encourage further refinement and development in the processing and utilization of VOs, offering valuable references for theoretical and applied research in food chemistry and food science.

A national registry from the Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE)

INTRODUCTION AND OBJECTIVES

Atrial fibrillation (AF) is the most common sustained arrhythmia, with significant burden for patients. Catheter ablation is safe and superior for symptom improvement. The purpose of this work was to assess how clinical practice compares with current scientific evidence and quality indicators for AF ablation.

METHODS

The Portuguese Association of Arrhythmology, Pacing and Electrophysiology conducted a prospective registry among Portuguese centers to assess clinical practice regarding management of patients referred for ablation and the methodology used in the procedures and related outcomes.

RESULTS

A total of 337 patients were referred for ablation, 102 (37.91%) female, age 65 (56-70.8) years. The median CHADS2-VaSC2 thromboembolic risk score was 2 (1-3), and 308 (92.49%) were on anticoagulants. AF was mainly paroxysmal (224, 66.97%) and symptomatic (mEHRA score 3; 2-3). Before ablation most patients (273, 81.49%) underwent cardiac computed tomography and only 24 (7.36%) procedures were performed with uninterrupted anticoagulation. For ablation, Carto® (194; 59.15%) and Ensite® (55; 16.77%) were mainly used, and the preferential strategy was pulmonary vein isolation (316; 94.61%). Acute complications occurred in five (1.49%) patients, while most had symptom improvement at one month (200; 86.21%), sustained at one year. There were 40 (12.6%) relapses within 30 days and 19 (26.39%) at one year.

CONCLUSIONS

In a population of patients with AF referred for ablation in Portuguese centers, patient management is provided according to the best scientific evidence and there is a high standard of practice with respect to the quality of AF ablation practice.

The quality of antimicrobial susceptibility test discs and implications for clinical outcomes

Disc diffusion remains the main technique for evaluating antibiotic activity in clinical microbiology laboratories. However, the assay protocol endorsed by the FDA, DIN, and WHO is invalid. Despite decades of research and practice in this field, the quantitative quality of manufactured discs is largely unknown, potentially leading to adverse clinical outcomes. The usual standards expected for new medical devices in terms of quality control, QA, and evidence-based assessment of outcomes are almost completely lacking. Recent data indicate that a large proportion of discs do not meet the specifications, and that disc diffusion is a poor predictor of clinical outcomes. In addition, lack of harmonisation between EUCAST and CLSI, despite many years of effort, strongly suggests that there are serious flaws in these systems. This area lacks scientific rigour, which may have also contributed to adverse clinical outcomes and the emergence of antimicrobial resistance.

Association between quality and quantity of carbohydrate intake with selected anthropometric indices among primary school girls in Kerman city, Iran: a cross-sectional study

BACKGROUND

The school-age is a crucial period of physical and cognitive growth, which requires an assessment of dietary intake and its influence on body weight and height. This study aims to determine the association between the quality and quantity of carbohydrate intake with selected anthropometric indices in primary school girls in Kerman City, Iran.

METHODS

This cross-sectional study was conducted on 330 primary school girls ages 6-12 years in Kerman. We used a validated and reliable dish-based 185-item food frequency questionnaire to evaluate people's food intake. We assessed the amount of carbohydrates in children's diets as the percentage of daily calories and grams per day. We used dietary fiber intake (grams/day), the glycemic load, the ratio of whole grain to total grain, and the ratio of solid carbohydrates to total carbohydrates to assess carbohydrate quality. Height, weight, and arm circumference were measured. We calculated body mass index (BMI) by dividing the weight in kilograms by the height in centimeters squared. We used the World Health Organization z-scores charts for girls 5 to 19 years old to assess z-scores for BMI-for-age (BAZ), height-for-age (HAZ), and weight-for-age (WAZ). Socioeconomic status and physical activity were assessed. We used ANOVA and ANCOVA statistical tests to assess the association between anthropometric indices and carbohydrate quantity and quality parameters.

RESULTS

Participants with the highest amount of carbohydrate intake had significantly higher anthropometric indices, including arm circumference, BMI-for-age z score (BAZ), and Height-for-age z score (HAZ) (p < 0.001, p < 0.001, and p = 0.009, respectively). With the increase in glycemic load (GL) and dietary fiber intake, anthropometric indices including arm circumference (GL: p < 0.001, Fiber: p < 0.001), BAZ (GL: p < 0.001, Fiber: P < 0.001), and HAZ (GL: P = 0.009, Fiber: p < 0.001) increased significantly.

CONCLUSIONS

We concluded that there was a positive association between the amount of carbohydrate intake and anthropometric indices (MUAC, BAZ, and HAZ). Also, with the increase in glycemic load and dietary fiber intake, the anthropometric indices including MUAC, BAZ, and HAZ increased.

Quality of antenatal care in 13 sub-Saharan African countries in the SDG era: evidence from Demographic and Health Surveys

BACKGROUND

Maternal and neonatal mortality remains high in sub-Saharan Africa (SSA) with women having 1 in 36 lifetime risk. The WHO launched the new comprehensive recommendations/guidelines on antenatal care (ANC) in 2016, which stresses the essence of quality antenatal care. Consequently, the objective of this cross-sectional study is to investigate the quality of ANC in 13 SSA countries.

METHODS

This is a cross-sectional study that is premised on pre-existing secondary data, spanning 2015 to 2021. Data for the study was obtained from the Measure DHS Programme and included a total of 79,725 women aged 15-49 were included. The outcome variable was quality ANC and it was derived as a composite variable from four main ANC services: blood pressure taken, urine taken, receipt of iron supplementation and blood sample taken. Thirteen independent variables were included and broadly categorised into individual and community-level characteristics. Descriptive statistics were used to present the proportion of women who had quality ANC across the respective countries. A two-level multilevel regression analysis was conducted to ascertain the direction of association between quality ANC and the independent variables.

RESULTS

The overall average of women who had quality ANC was 53.8% [CI = 51.2,57.5] spanning from 82.3% [CI = 80.6,85.3] in Cameroon to 11% [CI = 10.0, 11.4] in Burundi. Women with secondary/higher education had higher odds of obtaining quality ANC compared with those without formal education [aOR = 1.23, Credible Interval [Crl] = 1.10,1.37]. Poorest women were more likely to have quality ANC relative to the richest women [aOR = 1.21, Crl = 1.14,1.27]. Married women were more likely to receive quality ANC relative to those cohabiting [aOR = 2.04, Crl = 1.94,3.05]. Women who had four or more ANC visits had higher odds of quality ANC [aOR = 2.21, Crl = 2.04,2.38]. Variation existed in receipt of quality ANC at the community-level [σ2 = 0.29, Crl = 0.24,0.33]. The findings also indicated that a 36.2% variation in quality ANC is attributable to community-level factors.

CONCLUSION

To achieve significant improvement in the coverage of quality ANC, the focus of maternal health interventions ought to prioritise uneducated women, those cohabiting, and those who are unable to have at least four ANCs. Further, ample recognition should be accorded to the existing and potential facilitators and barriers to quality ANC across and within countries.

Amendments in surgical pathology reports: An 8-year institutional experience

Surgical pathology reports may undergo revisions broadly categorized as addenda (supplementary information) or amendments (changes to finalized reports). Amendments indicate potential flaws in the diagnostic process and serve as important indicators of vulnerabilities in the histopathology workflow. This study analyzed the frequency and distribution of amendments in surgical pathology reports over 8 years to identify patterns highlighting opportunities for improvement. Surgical biopsies, excisions, and resections were included; cytology and molecular tests were excluded. Amended reports were categorized using previously used taxonomy documented in literature. Defects were classified as misinterpretations, misidentifications, defective specimens, or defective reports. Of 101,355 reports, 155 (0.15 %) were signed out with amendments. The amendment rate was approximately 1-2 cases per 1000 reports annually. Misinterpretations accounted for the majority (52 %) of amended reports, with undercalls (62 %) and overcalls (27 %) being predominant subtypes. Tumor staging was amended in 57 (37 %) cases, with 30 being upstaged and 11 downstaged clinically. The highest number of misinterpretation defects occurred in head and neck (36 %) and breast (21 %) specimens. Misinterpretation defects were present in 53 % of malignant cases versus 42 % of benign cases. In 18 cases, there were significant changes in pathological diagnosis (14 major and 4 minor). A standard taxonomy categorizing report defects is crucial for measuring and improving quality control. Accurate pathology reporting impacts patient care and guides workflow improvements. This taxonomy enables us to track variations and deficiencies in our pathology reporting processes in a reproducible way across the department.

Multimode ultrasonic-assisted decontamination of fruits and vegetables: A review

Fruits and vegetables (F&V) are a significant part of our diet consumption. Microbial and pesticide residues are the predominant safety hazards of F&V consumption. Ordinary water washing has a very limited effect on removing microorganisms and pesticide residues and requires high water usage. Ultrasound, as an environmentally friendly technology, shows excellent potential for reducing microbial contamination and pesticide residue. This paper summarizes the research on ultrasound application in F&V washing, including the removal of microbial and pesticide residues and the comprehensive effect on their physicochemical characteristics. Furthermore, multimode ultrasonic-assisted techniques like multi-frequency and sequential ultrasound, combined with novel and conventional methods, can enhance the ultrasound-based effect and be more effective and sustainable in preventing F&V from microbial contamination. Overall, this work explicitly establishes the background on the potential for ultrasound cleaning and disinfection in the food industry as a green, effective, and ultimate method of preventing foodborne illnesses.

Quality assessment of videos on social media platforms related to gestational diabetes mellitus in China: A cross-section study

Purpose

This study aimed to systematically evaluate the quality of content and information in videos related to gestational diabetes mellitus on Chinese social media platforms.

Methods

The videos on various platforms, TikTok, Bilibili, and Weibo, were searched with the keyword "gestational diabetes mellitus" in Chinese, and the first 50 videos with a comprehensive ranking on each platform were included for subsequent analysis. Characteristic information of video was collected, such as their duration, number of days online, number of likes, comments, and number of shares. DISCREN, JAMA (The Journal of the American Medical Association) Benchmark Criteria, and GQS (Global Quality Scores) were used to assess the quality of all videos. Finally, the correlation analysis was performed among video features, video sources, DISCERN scores, and JAMA scores.

Results

Ultimately, 135 videos were included in this study. The mean DISCERN total score was 31.84 ± 7.85, the mean JAMA score was 2.33 ± 0.72, and the mean GQS was 2.00 ± 0.40. Most of the videos (52.6%) were uploaded by independent medical professionals, and videos uploaded by professionals had the shortest duration and time online (P < 0.001). The source of the video was associated with numbers of "likes", "comments", and "shares" for JAMA scores (P < 0.001), but there was no correlation with DISCERN scores. Generally, videos on TikTok with the shortest duration received the most numbers of "likes", "comments", and "shares", but the overall quality of videos on Weibo was higher.

Conclusion

Although the majority of the videos were uploaded by independent medical professionals, the overall quality appeared to be poor. Therefore, more efforts and actions should be taken to improve the quality of videos related to gestational diabetes mellitus.

Reported respectful maternity care received during childbirth at health facilities: A cross sectional survey in Eastern province, Rwanda

BACKGROUND

Respectful maternity care (RMC) fosters positive childbirth experiences and ensures safe motherhood. While past Rwandan studies on childbirth predominantly focused on negative experiences, our research delved into positive experiences. This study aimed to assess the RMC level experienced by women during childbirth in health facilities of Eastern Province of Rwanda.

METHODOLOGY

We conducted a cross-sectional survey on 610 mothers at their discharge across five public hospitals. We used a 15-items RMC questionnaire developed by White Ribbon Alliance, version of 2019. To manage the right-skewed data, we employed a median cut-off, categorizing experiences into binary outcome (low and high RMC score). We performed stepwise backward elimination logistic regression model to identify predictors of high RMC.

FINDINGS

The majority (70.2%) reported experiencing RMC. The most acclaimed RMC items (over 90%) included allowance of food and fluid intake (98.5%), non-discrimination (96.2%), receipt of necessary services (96.1%), and privacy (91.3%). The chi-square analysis showed an association between reported high RMC and marital status (p-value = 0.006), occupation (p-value = 0.001), and mode of delivery (p-value = 0.001). Caesarean section delivery was associated with high RMC in multivariate logistic regression with a p-value of 0.001, the adjusted odds ratio was 2.11 with a CI [1.40-3.17].

CONCLUSION

The reported RMC items and care appreciated at high level should be sustained. Regardless of mode of delivery, all mothers should experience consistent, utmost respect throughout the childbirth and should receive RMC at maximum level.

Underfunding of German university-based high-performance medicine exemplified by the treatment of varices in cirrhosis

Facing increasing economization in the health care sector, clinicians have to adapt not only to the ever-growing economic challenges, but also to a patient-oriented health care. Treatment costs are the most important variable for optimizing success when facing scarce human resources, increasing material- and infrastructure costs in general, as well as low revenue flexibility due to flat rates per case in Germany, the so-called Diagnosis-Related Groups (DRG). University hospitals treat many patients with particularly serious illnesses. Therefore, their share of complex and expensive treatments, such as liver cirrhosis, is significantly higher. The resulting costs are not adequately reflected in the DRG flat rate per case, which is based on an average calculation across all hospitals, which increases this economic pressure. Thus, the aim of this manuscript is to review cost and revenue structures of the management of varices in patients with cirrhosis at a university center with a focus on hepatology. For this monocentric study, the data of 851 patients, treated at the Gastroenterology Department of a University Hospital between 2016 and 2020, were evaluated retrospectively and anonymously. Medical services (e.g., endoscopy, radiology, laboratory diagnostics) were analyzed within the framework of activity-based-costing. As part of the cost unit accounting, the individual steps of the treatment pathways of the 851 patients were monetarily evaluated with corresponding applicable service catalogs and compared with the revenue shares of the cost center and cost element matrix of the German (G-) DRG system. This study examines whether university-based high-performance medicine is efficient and cost-covering within the framework of the G-DRG system. We demonstrate a dramatic underfunding of the management of varicose veins in cirrhosis in our university center. It is therefore generally questionable whether and to what extent an adequate care for this patient collective is reflected in the G-DRG system.

Smartphone-based imaging colorimetric assay for monitoring the quality of curcumin in turmeric powder

This research developed a colorimetric assay for semi-quantitative curcumin detection. The screening test was performed using a ferric chloride to form a brownish color which was further used to evaluate the amount of curcumin in the turmeric powder samples. The quantitative assay was performed based on the color intensity of the curcumin target using a smartphone digital image colorimetry with a developed lightbox constructed with a white light-emitting diodes (LED) light source as the measurement device. Images in red, green, and blue (RGB) color were processed to obtain relevant colors from the image and the color values were used to analyze curcumin concentrations. The intensity of the ΔB was correlated to the concentration of curcumin with high sensitivity. The method showed a linear range between 0.25 and 5 mg L-1 with the LOD and LOQ of 0.12 and 0.41 mg L-1, respectively. Sample analysis was carried out in turmeric powders. Curcumin in turmeric powder samples was simply extracted using acetonitrile followed by dilution 100 times for sample preparation. The accuracy was tested by spiking 0.25, 1.00, and 4.00 mg L-1 of standard curcumin into the turmeric sample solution. The average percentage recoveries were acceptable in all samples (90-104%). The method was validated by comparing the results obtained from the proposed method and high-performance liquid chromatography (HPLC). There was no statistically significant difference between the two methods (P = 0.05).

Temporal and geographical variations in diagnostic imaging in Norway

BACKGROUND

Unwarranted temporal and geographical variations are acknowledged as a profound problem for equal access and justice in the provision of health services. Even more, they challenge the quality, safety, and efficiency of such services. This is highly relevant for imaging services.

OBJECTIVE

To analyse the temporal and geographical variation in the number of diagnostic images in Norway from 2013 to 2021.

METHODS

Data on outpatient imaging provided by the Norwegian Health Economics Administration (HELFO) and inpatient data afforded by fourteen hospital trusts and hospitals in Norway. Data include the total number of imaging examinations according to the Norwegian Classification of Radiological Procedures (NCRP). Analyses were performed with descriptive statistics.

RESULTS

More than 37 million examinations were performed in Norway during 2013-2021 giving an average of 4.2 million examinations per year. In 2021 there was performed and average of 0.8 examinations per person and 2.2 examinations per person for the age group > 80. There was a 9% increase in the total number of examinations from 2013 to 2015 and a small and stable decrease of 0.5% per year from 2015 to 2021 (with the exception of 2020 due to the pandemic). On average 71% of all examinations were outpatient examinations and 32% were conducted at private imaging centres. There were substantial variations between the health regions, with Region South-East having 53.1% more examinations per inhabitant than Region West. The geographical variation was even more outspoken when comparing catchment areas, where Oslo University Hospital Trust had twice as many examinations per inhabitant than Finnmark Hospital Trust.

CONCLUSION

As the population in Norway is homogeneous it is difficult to attribute the variations to socio-economic or demographic factors. Unwarranted and supply-sensitive variations are challenging for healthcare systems where equal access and justice traditionally are core values.

Positive contributions of the stem to the formation of white tea quality-related metabolites during withering

Most teas, including white tea, are produced from tender shoots containing both leaf and stem. However, the effect of the stem on white tea quality remains unclear, especially during withering, an essential process. Therefore, this study investigated the withering-induced changes in the leaves and stems of Camellia sinensis cv. 'Fudingdabai' by multi-group analysis. During withering, the levels of catechin and theobromine (i.e., major flavor-related compounds) decreased slightly, mainly in the leaves. The abundance of some proteinaceous amino acids related to fresh taste increased in stems due to increased protein hydrolysis. In addition, changes in biosynthetic pathways caused a decrease in theanine (a major non-proteinaceous amino acid) and an increase in gamma-aminobutyric acid in stems. Terpenes, mainly in the stems, were partially affected by withering. Phenylacetaldehyde, a major contributor to white tea aroma, increased mainly in the stems. These findings reflect the positive contribution of the stem to white tea quality.

Implementation of a traceability system and safe manufacturing medications in a clean room

OBJECTIVE

To describe the process of implementing a traceability and safe drug manufacturing system in the clean room of a Pharmacy Service to increase patient safety, in accordance with current legislation.

METHODS

The process was carried out between September 2021 and July 2022. The software program integrated all the recommended stages of the manufacturing process outlined in the "Good Practices Guide for Medication Preparation in Pharmacy Services" (GBPP). The following sections were parameterized in the software program: personnel, facilities, equipment, starting materials, packaging materials, standardized work procedures, and quality controls.

RESULTS

A total of 50 users, 4 elaboration areas and 113 equipments were included. 435 components were parameterized (195 raw materials and 240 pharmaceutical specialties), 54 packaging materials, 376 standardized work procedures (123 of them corresponding to sterile medicines and 253 to non-sterile medicines, of which 52 non-sterile were dangerous), in addition 17 were high risk, 327 medium risk, 32 low risk, and 13 quality controls.

CONCLUSIONS

The computerization of the production process has allowed the implementation of a traceability and secure drug manufacturing system in a controlled environment in accordance with current legislation.

A systematic review and meta-analysis of English language online patient education materials in breast cancer: Is readability the only story?

BACKGROUND

Online patient education materials (OPEMs) are an increasingly popular resource for women seeking information about breast cancer. The AMA recommends written patient material to be at or below a 6th grade level to meet the general public's health literacy. Metrics such as quality, understandability, and actionability also heavily influence the usability of health information, and thus should be evaluated alongside readability.

PURPOSE

A systematic review and meta-analysis was conducted to determine: 1) Average readability scores and reporting methodologies of breast cancer readability studies; and 2) Inclusion frequency of additional health literacy-associated metrics.

MATERIALS AND METHODS

A registered systematic review and meta-analysis was conducted in Ovid MEDLINE, Web of Science, Embase.com, CENTRAL via Ovid, and ClinicalTrials.gov in June 2022 in adherence with the PRISMA 2020 statement. Eligible studies performed readability analyses on English-language breast cancer-related OPEMs. Study characteristics, readability data, and reporting of non-readability health literacy metrics were extracted. Meta-analysis estimates were derived from generalized linear mixed modeling.

RESULTS

The meta-analysis included 30 studies yielding 4462 OPEMs. Overall, average readability was 11.81 (95% CI [11.14, 12.49]), with a significant difference (p < 0.001) when grouped by OPEM categories. Commercial organizations had the highest average readability at 12.2 [11.3,13.0]; non-profit organizations had one of the lowest at 11.3 [10.6,12.0]. Readability also varied by index, with New Fog, Lexile, and FORCAST having the lowest average scores (9.4 [8.6, 10.3], 10.4 [10.0, 10.8], and 10.7 [10.2, 11.1], respectively). Only 57% of studies calculated average readability with more than two indices. Only 60% of studies assessed other OPEM metrics associated with health literacy.

CONCLUSION

Average readability of breast cancer OPEMs is nearly double the AMA's recommended 6th grade level. Readability and other health literacy-associated metrics are inconsistently reported in the current literature. Standardization of future readability studies, with a focus on holistic evaluation of patient materials, may aid shared decision-making and be critical to increased screening rates and breast cancer awareness.

Defining quality indicators, pharmaceutical care bundles and outcomes of clinical pharmacy service delivery using a Delphi consensus approach

BACKGROUND

Clinical pharmacy quality indicators are often non-uniform and measure individual activities not linked to outcomes.

AIM

To define a consensus agreed pharmaceutical care bundle and patient outcome measures across an entire state health service.

METHOD

A four-round modified-Delphi approach with state Directors of Pharmacy was performed (n = 25). They were asked to rate on a 5-point Likert scale the relevance and measurability of 32 inpatient clinical pharmacy quality indicators and outcome measures. They also ranked clinical pharmacy activities in order from perceived most to least beneficial. Based upon these results, pharmaceutical care bundles consisting of multiple clinical pharmacy activities were formed, and relevance and measurability assessed.

RESULTS

Response rate ranged from 40 to 60%. Twenty-six individual clinical pharmacy quality indicators reached consensus. The top ranked clinical pharmacy quality indicator was 'proportion of patients where a pharmacist documents an accurate list of medicines during admission'. There were nine pharmaceutical care bundles formed consisting between 3 and 7 activities. Only one pharmaceutical care bundle reached consensus: medication history, adverse drug reaction/allergy documentation, admission and discharge medication reconciliation, medication review, provision of medicines education and provision of a medication list on discharge. Sixteen outcome measures reached consensus. The top ranked were hospital acquired complications, readmission due to medication misadventure and unplanned readmission within 10 days.

CONCLUSION

Consensus has been reached on one pharmaceutical care bundle and sixteen outcomes to monitor clinical pharmacy service delivery. The next step is to measure the extent of pharmaceutical care bundle delivery and the link to patient outcomes.

Microencapsulation of ultrasound-assisted phenolic extracts of sugar maple leaves: Characterization, in vitro gastrointestinal digestion, and storage stability

Sugar maple leaves (SML), usually considered residue plant biomass and discarded accordingly, contain a considerable amount of phenolic antioxidants. In this study, SML phenolics were extracted employing both advanced (homogenization pretreated ultrasound-assisted extraction) and conventional (maceration) methods followed by their encapsulation by freeze drying and spray drying using a combination of maltodextrin and gum arabic as coating agents. Detailed physicochemical analyses revealed that the encapsulated microparticles had high solubility (>90 %) and encapsulation efficiency (>95 %), acceptable thermal stability with good handling properties. Phenolic compounds were completely released from microparticles during simulated gastric conditions. The microparticles influenced the bioaccessibility of more than 43 % of the phenolic fraction in the intestinal phase. The antioxidant capacity of the microparticles was preserved during storage. These findings suggest the effectiveness of the microencapsulation process for producing high quality microparticles of SML phenolic extracts and the possibility of their use in the food, nutraceutical, bio-pharmaceutical sectors.

Assessment of discordance between radiologists and emergency physicians of RADIOgraphs among discharged patients in an emergency department: the RADIO-ED study

BACKGROUND

The possibility to perform standard X-rays is mandatory for all French Emergency Department (ED). Initial interpretation is under the prescriber emergency physician-who continually works under extreme conditions, but a radiologist needs to describe a report as soon as possible. We decided to assess the rate of discordance between emergency physicians and radiologists among discharged patients.

METHODS

We performed a monocentric study on an adult ED among discharged patients who had at least one X-ray during their consult. We used an automatic electronic system that classified interpretation as concordant or discordant. We review all discordant interpretation, which were classified as false negative, false positive, or more exam needed.

RESULTS

For 1 year, 8988 patients had 12,666 X-rays. We found a total of 742 (5.9%) discordant X-rays, but only 277 (2.2%) discordance had a consequence (new consult or exam not initially scheduled). We found some factors associated with discordance such as male sex, or ankle, foot, knee, finger, wrist, ribs, and elbow locations.

CONCLUSIONS

On discharged patients, using a systematic second interpretation of X-ray by a radiologist, we found a total of 2.2% discordance that had an impact on the initial care.

Combined treatment of pulsed light and nisin-organic acid based antimicrobial wash for inactivation of Escherichia coli O157:H7 in Romaine lettuce, reduction of microbial loads, and retention of quality

Microbial safety of fresh produce continues to be a major concern. Novel antimicrobial methods are needed to minimize the risk of contamination. This study investigated the antimicrobial efficacy of pulsed light (PL), a novel nisin-organic acid based antimicrobial wash (AW) and the synergy thereof in inactivating E. coli O157:H7 on Romaine lettuce. Treatment effects on background microbiota and produce quality during storage at 4 °C for 7 days was also investigated. A bacterial cocktail containing three outbreak strains of E. coli O157:H7 was used as inoculum. Lettuce leaves were spot inoculated on the surface before treating with PL (1-60 s), AW (2 min) or combinations of PL with AW. PL treatment for 10 s, equivalent to fluence dose of 10.5 J/cm2, was optimal and resulted in 2.3 log CFU/g reduction of E. coli O157:H7, while a 2 min AW treatment, provided a comparable pathogen reduction of 2.2 log CFU/g. Two possible treatment sequences of PL and AW combinations were investigated. For PL-AW combination, inoculated lettuce leaves were initially exposed to optimum PL dose followed by 2 min AW treatment, whereas for AW-PL combination, inoculated lettuce were subjected to 2 min AW treatment prior to 10 s PL treatment. Both combination treatments (PL-AW and AW-PL) resulted in synergistic inactivation as E. coli cells were not detectable after treatment, indicating >5 log pathogen reductions. Combination treatments significantly (P < 0.05) reduced spoilage microbial populations on Romaine lettuce and also hindered their growth in storage for 7 days. The firmness and visual quality appearance of lettuce were not significantly (P > 0.05) influenced due to combination treatments. Overall, the results reveal that PL and AW combination treatments can be implemented as a novel approach to enhance microbial safety, quality and shelf life of Romaine lettuce.

Outcome Heterogeneity in Prehabilitation Trials-Are We Comparing Apples and Oranges?

INTRODUCTION

Over the last decade, the number of prehabilitation randomised controlled trials (RCTs) has increased significantly. Therefore, this review aimed to describe the outcomes reported in prehabilitation RCTs in patients undergoing cancer surgery.

METHODS

A search was conducted in Embase, Allied and Complementary Medicine Database, The Cochrane Library, PsycINFO, MEDLINE, and Cumulated Index to Nursing and Allied Health Literature from inception to July 2021. We included RCTs evaluating the effectiveness of preoperative exercise, nutrition, and psychological interventions on postoperative complications and length of hospital stay in adult oncology patients who underwent thoracic and gastrointestinal cancer surgery. The verbatim outcomes reported in each article were extracted, and each outcome was assessed to determine whether it was defined and measured using a validated tool. Verbatim outcomes were grouped into standardized outcomes and categorized into domains. The quality of outcome reporting in each identified article was assessed using the Harman tool (score range 0-6, where 0 indicated the poorest quality).

RESULTS

A total of 74 RCTs were included, from which 601 verbatim outcomes were extracted. Only 110 (18.3%) of the verbatim outcomes were defined and 270 (44.9%) were labeled as either "primary" or "secondary" outcomes. Verbatim outcomes were categorized into 119 standardized outcomes and assigned into one of five domains (patient-reported outcomes, surgical outcomes, physical/functional outcomes, disease activity, and intervention delivery). Surgical outcomes were the most common outcomes reported (n = 71 trials, 95.9%). The overall quality of the reported outcomes was poor across trials (median score: 2.0 [IQR = 0.00-3.75]).

CONCLUSIONS

Prehabilitation RCTs display considerable heterogeneity in outcome reporting, and low outcome reporting quality. The development of standardized core outcome sets may help improve article quality and enhance the clinical utility of prehabilitation following cancer surgery.

Online information for spontaneous coronary artery dissection (SCAD) survivors and their families: A systematic appraisal of content and quality of websites

BACKGROUND

Spontaneous coronary artery dissection (SCAD) survivors often seek information online. However, the quality and content of websites for SCAD survivors is uncertain. This review aimed to systematically identify and appraise websites for SCAD survivors.

METHODS

A systematic review approach was adapted for websites. A comprehensive search of SCAD key-phrases was performed using an internet search engine during January 2023. Websites targeting SCAD survivors were included. Websites were appraised for quality using Quality Component Scoring System (QCSS) and Health Related Website Evaluation Form (HRWEF), suitability using the Suitability Assessment Method (SAM), readability using a readability generator, and interactivity. Content was appraised using a tool based on SCAD international consensus literature. Raw scores from tools were concerted to percentages, then classified variably as excellent through to poor.

RESULTS

A total of 50 websites were identified and included from 600 screened. Overall, content accuracy/scope (53.3 ± 23.3) and interactivity (67.1 ± 11.5) were poor, quality was fair (59.1 ± 22.3, QCSS) and average (83.1 ± 5.8, HRWEF) and suitability was adequate (54.9 ± 13.8, SAM). The mean readability grade was 11.6 (±2.3), far exceeding the recommendations of ≤ 8. By website type, survivor affiliated and medically peer-reviewed health information websites scored highest. Appraisal tools had limitations, such as overlapping appraisal of similar things and less relevant items due to internet modernity.

CONCLUSION

Many online websites are available for SCAD survivors, but often have limited and/or inaccurate content, poor quality, are not tailored to the demographic, and are difficult to read. Appraisal tools for health website require consolidation and further development.

Burdens of infection control on healthcare workers: a scoping review

INTRODUCTION

Hospital-acquired infections (HAIs) pose a significant risk to patients, and are a major focus of infection prevention and control policies (IPC). One under-recognized reason for the generally poor compliance with IPC is that it is burdensome for healthcare workers (HCWs).

AIM

To identify the burdens of IPC for HCWs.

METHODS

PubMed and CINAHL were searched for studies published in English since 2000 regarding compliance with IPC and the burdens associated with compliance. After screening 1018 initial results, 25 articles were included in the final review.

RESULTS

Evidence was found for burdens including dermatological complications, headaches, sensory symptoms and time pressure. Tools designed to measure compliance with IPC have limitations, and rarely assess the burdens of compliance. A strong safety culture predicted positive compliance, while knowledge of the underlying rationale for IPC had a non-linear relationship with compliance.

CONCLUSION

Future research should clarify IPC-related burdens and how these may be minimized to achieve better compliance.

An agro-physiological dataset on industrial tomatoes from nine years of field experiments conducted with alternative water-saving strategies in Mediterranean environments

The availability of field experimental data plays a pivotal role in advancing agricultural research, particularly in the Mediterranean, where farmers face significant challenges due to water scarcity and changing climatic conditions. We present a multi-year homogenized dataset of agro-physiological traits collected on industrial tomatoes and focused on the effect of deficit irrigation (DI). The dataset has been compiled over nine years and comprises 100 experimental plots, where 32 DI strategies have been tested. Visual observations on tomato phenology and qualitative and quantitative production data have been collected in field and laboratory surveys, complemented with detailed information on pedo-climatic conditions and irrigation scheduling (timing and volume). Researchers can find in this dataset a rich source for calibrating and evaluating agro-physiological models and a reference basis to study the relationships between DI strategies, weather variability, and the performance of tomato growing systems. Agronomists from the public and private sectors can gain domain knowledge to support local farmers with the best DI strategies to achieve high yields while optimizing water use. Moreover, this dataset serves as ground truth for digital decision support systems, which need real-world data to enhance their accuracy in guiding farmers on efficient water use. This data source is intended to become a crucial asset for researchers, agronomists, and decision-makers in the Mediterranean as it bridges the gap between research and practice in an area where farmers are already striving with water scarcity for industrial tomato cultivation.

Autumn in New York: The Case of Long-Term Care Facilities in the "Safe Staffing" Lawsuit With Less Staffing But Similar COVID-19 Outcomes

BACKGROUND AND OBJECTIVES

In 2022, 239 New York state long-term care facilities (LTCFs) challenged a "Safe Staffing" law in court. Our study compares LTCFs involved and not involved in the lawsuit, testing for differences in staffing measures and resident outcomes during the first year of the coronavirus disease 2019 (COVID-19) pandemic.

RESEARCH DESIGN AND METHODS

New York LTCF-level data were obtained from the Centers for Medicare and Medicaid Services 2019 organization and 2020 COVID-19 data files. These data were then linked to data from the Long-Term Care Community Coalition, which identified the LTCFs involved in the "Safe Staffing" lawsuit. We first tested for differences in reported 2019 staffing levels by lawsuit involvement. Second, we specified "Doubly Robust" regression models to test if lawsuit involvement was associated with differences in resident COVID-19 infections, COVID-19 deaths, and overall mortality.

RESULTS

LTCFs involved in the lawsuit reported lower staff ratings and fewer staffing hours compared to LTCFs not involved in the lawsuit. Despite finding higher rates of admissions with COVID-19 in LTCFs involved in the lawsuit, we did not find that COVID-19 infections, COVID-19 deaths, or overall mortality differed by lawsuit involvement.

DISCUSSION AND IMPLICATIONS

LTCFs involved in the lawsuit were deemed by policymakers as reducing staff, earning excess profits, and placing residents at risk. While these LTCFs reported lower staffing levels, we observed no differences in resident outcomes during the first year of the COVID-19 pandemic. Researchers and policymakers should develop more nuanced perspectives concerning the relationship among LTCF staffing, outcomes, and organizational profitability.

Quantitative assessment of anterior talofibular ligament quality in chronic lateral ankle instability using magnetic resonance imaging T2* value

OBJECTIVE

To determine T2* normal reference values for anterior talofibular ligament (ATFL) and to investigate the feasibility of the quantitative ATFL quality evaluation in chronic lateral ankle instability (CLAI) using T2* values.

MATERIALS AND METHODS

This study enrolled 15 patients with CLAI and 30 healthy volunteers. The entire ATFL T2* values from the MRI T2* mapping were measured. The prediction equation (variables: age, height, and weight) in a multiple linear regression model was used to calculate the T2* normal reference value in the healthy group. T2* ratio was defined as the ratio of the actual T2* value of the patient's ATFL to the normal reference value for each patient. A Telos device was used to measure the talar tilt angle (TTA) from the stress radiograph.

RESULTS

T2* values of ATFL in the healthy and CLAI groups were 10.82 ± 1.84 ms and 14.36 ± 4.30 ms, respectively, which are significantly higher in the CLAI group (P < 0.05). The prediction equation of the normal reference T2* value was [14.9 + 0.14 × age (years) - 4.7 × height (m) - 0.03 × weight (kg)] (R2 = 0.65, P < 0.0001). A significant positive correlation was found between the T2* ratio and TTA (r = 0.66, P = 0.007).

CONCLUSION

MRI T2* values in patients with CLAI were higher than those in healthy participants, and the T2* ratio correlated with TTA, suggesting that T2* values are promising for quantitative assessment of ATFL quality preoperatively.

Bringing Enhanced Recovery After Surgery to the NICU: An Implementation Trial

INTRODUCTION

Enhanced Recovery After Surgery (ERAS) guidelines are bundled evidence-informed recommendations implemented to improve quality and safety of perioperative care. This study aims to determine feasibility of NICU implementation of an ERAS Guideline for Intestinal Resection, describing clinical outcomes and adherence to recommendations following light-touch implementation.

METHODS

Infants <28 days undergoing laparotomy for intestinal resection in a closed-NICU were prospectively enrolled. Exclusion criteria included prematurity (<32wks), instability, or major comorbidity. Clinical data reflecting 13 ERAS recommendations were collected through chart review. Descriptive statistics are presented as median [interquartile range]. Thirty-day post-discharge outcomes include NICU and hospital length of stay (LOS), ventilator days, surgical site infection (SSI), re-intubation, readmission, reoperation, and mortality. Adherence was calculated as the percentage of patients eligible for each recommendation whose care was adherent.

RESULTS

Ten infant-parent dyads were enrolled (five females; GA 37 weeks [35, 38.8]; birthweight 2.97 kg [2.02, 3.69]). Surgical diagnoses included intestinal atresia/web (n = 6), anorectal malformation (n = 3), and segmental volvulus (n = 1). NICU LOS was 16 days [11, 21], hospital LOS 20 days [18, 30], and 2.5 ventilator days/patient [2, 3]. There was reduced opioid use, no SSIs, one re-intubation, three readmissions, three reoperations, and no mortalities. Adherence to ERAS recommendations ranged 0-100 % with a pooled adherence rate of 73 %.

CONCLUSION

It is feasible to introduce ERAS to the NICU with acceptable overall adherence. Assessing adherence was challenging for some measures. There were promising early clinical findings including a reduction in opioid use. This implementation trial will inform development of an ERAS protocol for surgical NICUs.

LEVEL OF EVIDENCE

IV (Cohort Study).

Recent advances in postharvest technologies for reducing chilling injury symptoms of fruits and vegetables: A review

Low temperature storage is widely used in the storage and transportation of postharvest fruits and vegetables. However, the negative effects of chilling injury (CI) on certain fruits and vegetables cannot be ignored. Therefore, efficient CI prevention technologies were used for reducing CI. This paper expounds the mechanisms of CI, common symptoms of CI and its impacts on the quality of fruits and vegetables, and summarizes the application of CI prevention technology. CI control methods are mainly classified into physical treatments (hot shock, near-freezing storage, high relative humidity storage, light-proof storage, and electromagnetic field), chemical treatments (melatonin, 1-methylcyclopropene, astragalus polysaccharides, γ-aminobutyric acid, 24-epibrassinolide, methyl jasmonate, trisodium phosphate, glycine betaine, and salicylic acid, etc.), coating treatments (sodium alginate, chitosan, carboxymethyl cellulose and aloe vera gel, etc.) and their combined treatments. These treatments have enhanced antioxidant activity, enzyme activity, membrane system integrity, and energy levels, thereby reducing the CI of fruits and vegetables.

Effect of plasma-activated lactic acid on microbiota composition and quality of puffer fish (Takifugu obscurus) fillets during chilled storage

Fresh puffer fish (Takifugu obscurus) are susceptible to microbial contamination and have a very short shelf-life of chilled storage. Hence, this study aimed to evaluate the effects of plasma-activated lactic acid (PALA) on microbiota composition and quality attributes of puffer fish fillets during chilled storage. The results showed that PALA treatment effectively reduced the growth of bacteria and attenuated changes in physicochemical indicators (total volatile basic nitrogen, pH value, K value, and biogenic amines) of puffer fish fillets. Additionally, insignificant changes were observed in lipid oxidation during the first 8 days (p > 0.05). Illumina-MiSeq high-throughput sequencing revealed that PALA effectively inhibited the growth of Pseudomonas in puffer fish fillets and maintained the diverse characteristics of the microbial community. In combination with sensory analysis, PALA extended the shelf life of puffer fish fillets for 4 days, suggesting that PALA could be considered a potential fish fillet preservation method.

Back propagation artificial neural network (BP-ANN) for prediction of the quality of gamma-irradiated smoked bacon

This study investigated the effect of gamma irradiation on smoked bacon quality during storage and developed a multi-quality prediction model based on gamma irradiation. Gamma irradiation reduced moisture content and improved the microbial safety of smoked bacon. It also accelerated protein and lipid oxidation and altered free amino acids and fatty acids composition. It was effective in slowing down quality deterioration and sensory quality decline during storage. The backpropagation artificial neural network (BP-ANN) model was constructed by using physical and chemical indicators, irradiation dose, and storage time as input variables, and the total number of colonies and sensory scores as output layers. The transfer functions of the input-hidden layer and hidden-output layer were ReLu and Sigmoid, respectively. There were 13 neurons in the hidden layer. Results showed that BP-ANN based on physical and chemical indicators, irradiation dose, and storage time had great potential in predicting the multiple quality of smoked bacon.

Response surface methodology to optimize the sterilization process of slightly acidic electrolyzed water for Chinese shrimp (Fenneropenaeus chinensis) and to investigate its effect on shrimp quality

Chinese shrimps are popular among consumers for their delicious taste and high nutritional value, but they are highly susceptible to deterioration due to microbial contamination with degradation of texture, color and flavor. The aim of this study was to evaluate the effects of available chlorine concentration (ACC), processing time and material-liquid ratio on the bacterial inhibition rate of shrimp treated with slightly acidic electrolyzed water (SAEW). The effective parameters were optimized by response surface methodology to the optimal bactericidal conditions: ACC 88 mg/L, processing time 12 min, and material-liquid ratio 1:4. The actual bactericidal inhibition rate of shrimp under these conditions was 37.60 %. On this basis, the quality, color difference and textural changes of shrimp treated with SAEW, sodium hypochlorite and alkaline electrolytic water were compared and investigated during storage at 4 °C. The combined results showed that the SAEW treatment could extend the shelf-life by more than 2 d.

Advancements, limitations and challenges in hyperspectral imaging for comprehensive assessment of wheat quality: An up-to-date review

The potential of hyperspectral imaging technology (HIT) for the determination of physicochemical and nutritional components, evaluation of fungal/mycotoxins contamination, wheat varieties classification, identification of non-mildew-damaged wheat kernels, as well as detection of flour adulteration is comprehensively illustrated and reviewed. The latest findings (2018-2023) of HIT in wheat quality evaluation through internal and external attributes are compared and summarized in detail. The limitations and challenges of HIT to improve assessment accuracy are clearly described. Additionally, various practical recommendations and strategies for the potential application of HIT are highlighted. The future trends and prospects of HIT in evaluating wheat quality are also mentioned. In conclusion, HIT stands as a cutting-edge technology with immense potential for revolutionizing wheat quality evaluation. As advancements in HIT continue, it will play a pivotal role in shaping the future of wheat quality assessment and contributing to a more sustainable and efficient food supply chain.

Bamboo shoots improve the nutritional and sensory quality, and change flavor composition of chicken soup

The effect of adding bamboo shoots to stewing on the quality and flavor of chicken soup has never been reported. Therefore, this study investigated the effects of 4 kinds of bamboo shoots on the edible quality, volatile and water-soluble flavor components of Chahua chicken soup. The results showed that adding bamboo shoots changed the sensory and nutritional quality of chicken soup. A total of 62 volatile flavor components were identified by HS-SPME-GC-MS, of which 12 were identified as characteristic volatile flavor components, and 9 were the main reasons for the flavor differences between bamboo shoot chicken soup with blank chicken soup. LC-MS found that after adding bamboo shoots, the differential water-soluble components in chicken soup significantly increased, and most of the increased components have been proven to have physiological functional activity. In conclusion, adding bamboo shoots improved the nutritional and sensory quality, and changed the flavor components of chicken soup.

Regulating effects of low salt dry-curing pre-treatment on microbiota, biochemical changes and flavour precursors of grass carp (Ctenopharyngodon idella) fillets during storage at 4 °C

Low salt dry-curing (LSD), as a healthier pre-treatment for the preservation of fishery products, is a potential technique substitute for excessively salty curing. The regulatory effects of 2 % and 3 % LSD on the quality evolution through an intrinsic correlation between microbiota succession and flavour precursors of refrigerated grass carp fillets were investigated in this study. The results showed that the LSD pre-treatment was effective in promoting proteolysis, free amino acid and fatty acid metabolism with the microbiota succession and quality evolution. Compared with unpre-treated samples, the 3 % LSD pre-treatment effectively extended the shelf life by 10 days within the acceptable quality attributes. Not only did the LSD pre-treatment lead to catalytic microbiota succession and inhibitive spoilage substance production but it also improved the flavour precursors, which are taste-active amino acids and polyunsaturated fatty acids (PUFAs). Moreover, considerable correlations between quality attributes, taste-active amino acids, PUFAs and microbiota were obtained.