The use of NexoBrid™ enzymatic debridement and coagulation abnormalities.

OBJECTIVES: Current evidence on how the use of bromelain-based enzymatic debridement techniques (NexoBrid™) affect patient coagulation is limited. A single patient case report [1] suggests that a patient with 15% total body surface area (TBSA) burn developed decreased coagulation activity following debridement with NexoBrid™ enzymatic debridement (ED). Regional Burns Centres in the United Kingdom may be reluctant to use ED, particularly in larger burns, citing concerns regarding coagulation. At our centre we have routinely used ED on deep partial thickness burns since 2017 including on patients with burns over 15% TBSA. This study aims to investigate whether there is a significant disruption in coagulation in patients undergoing ED with burns > 15% TBSA or admitted to intensive care compared to the standard of care (SOC) which is surgical debridement in theatre. METHODS: This single-centre retrospective study includes all patients with a burn treated with ED at Pinderfields General Hospital Regional Burns Centre intensive care unit (ITU) from 2017 to 2020. Patients were matched to those treated with SOC at the same centre by age, % TBSA burn and presence of inhalational injury. These parameters correlate with the Baux score [9]. Percentage of burn debrided was matched as closely as possible, with coagulation profiles and platelet count taken the day before, the day of and three days following surgery. RESULTS: Thirty-one patients were treated with ED in the intensive care unit between 2017 and 2020. Four patients were excluded due to insufficient records and one patient was anti-coagulated. Twenty-six patients were included and matched as described above. Average age of patients receiving ED was 44 years, the same in the matched group. Average TBSA burn is 35.5% (35.8% in matched group). No statistically significant difference in coagulation was seen between patients undergoing ED compared to SOC when considering prothrombin time (PT), activated partial thromboplastin time (aPTT) and platelet count. Both groups slightly breached the upper limit of normal on day 2 post ED and SOC. There was a slight breach of the lower limit of the average platelet count on day 2 post-ED which was neither statistically nor clinically significant. CONCLUSIONS: Large burns are associated with coagulation abnormalities, therefore isolating a single variable in this cohort is challenging. However, this study found no significant change following ED use when compared to SOC and therefore no convincing evidence that ED is associated with coagulation abnormalities. This study represents one of the largest focusing on coagulation abnormalities following the use of ED, as the current literature is limited. Our study suggests that concerns regarding coagulation abnormalities should not prevent patients with large, deep partial thickness burns or full thickness burns being treated with ED.

The effect of aquaponics on tomato (Solanum lycopersicum) sensory, quality, and safety outcomes.

Resource-efficient food production practices are needed to support a sustainable food system. Aquaponics, a system where fish and produce are grown symbiotically in the same water circulating system, minimizes water usage, fertilizer input, and waste production. However, the impact of aquaponics on produce quality is underexplored. We utilize objective testing, descriptive analysis, and consumer acceptance to characterize the impact of aquaponics on tomato quality. Two tomato varieties were grown in an aquaponics system and compared with soil-grown controls across 3 years. Safety was assessed by analyzing coliforms and confirming the absence of Escherichia coli. Weight, texture, color, moisture, titratable acidity, brix, and phenolic and antioxidant measurements were assessed. A semitrained descriptive sensory panel assessed 13 tomato attributes and acceptance was determined using untrained participants. Aquaponic tomatoes were frequently lighter and yellower in color and lower in brix. Descriptive analysis indicated significant differences in several sensory attributes, though these findings were inconsistent between years and varieties. Nutrient deficiencies may explain quality differences, as iron supplementation improved outcomes. Notably, the objective and descriptive differences minimally impacted consumer acceptance, as we found no significant differences in taste, texture, or appearance liking between production method in either variety. Despite variation in produce quality across years, aquaponics tomatoes pose minimal E. coli risk and are liked as much as soil-grown tomatoes. These findings demonstrate that aquaponics can produce products that are as acceptable as their soil-grown counterparts. PRACTICAL APPLICATION: Aquaponic tomatoes are as safe as soil-grown tomatoes. Furthermore, aquaponics tomatoes are liked as much as soil-grown tomatoes. Careful monitoring of nutrients in an aquaponic system may optimize quality. Overall, aquaponics has a minimal impact on tomato quality and thus is a sustainable food production method that can compete with conventional products on quality.

Health- or Environmental-Focused Text Messages to Increase Consumption of a Sustainable Diet among Young Adults: Importance of Expected Taste.

Taste is a frequently cited barrier to the greater adoption of plant-based foods, a dietary pattern associated with both health and environmental benefits. To examine the role of expected taste in promoting greater adoption of plant-based foods, we examined the impact of a text-message intervention on the expected taste of both meat- and plant-protein foods. Young adults (n = 159) were randomly assigned to receive either health- or environment-focused text messages twice a week for eight weeks. Study measures (pre- and post-) included dietary recalls, the expected tastiness of meat- and plant-protein images and plant-based diets, consumption intention, and person-related factors such as moral satisfaction and the subjective norms of plant-based eating and health and environmental values. Participants rating plant-protein foods tastier at baseline were more likely to report higher actual (p < 0.001) and intended (p = 0.017) consumption of plant proteins following the intervention. While text messages had a limited effect on altering the expected taste of specific plant-protein foods, the messages did elevate the expected tastiness of plant-based diets. Baseline person-related factors positively predicted changes in expected tastiness of plant-based diets. Messages promoting plant-based foods may be more effective if these foods are first perceived as tasty. Furthermore, incorporating person-related considerations into messaging strategies may improve the expected taste of plant-based foods.

Piceatannol, a Dietary Polyphenol, Alleviates Adipose Tissue Loss in Pre-Clinical Model of Cancer-Associated Cachexia via Lipolysis Inhibition.

Cancer-associated cachexia (CAC) is the nutrition-independent loss of lean muscle and adipose tissues, and results in reduced chemotherapy effectiveness and increased mortality. Preventing adipose loss is considered a key target in the early stages of cachexia. Lipolysis is considered the central driver of adipose loss in CAC. We recently found that piceatannol, but not its analogue resveratrol, exhibits an inhibitory effect on lipolysis. The objective of this study was to investigate the role of piceatannol in cancer-associated lipolysis and cachexia-induced weight loss. Cancer cell-induced lipolysis in adipocytes was stimulated using cancer-conditioned media (CCM) or co-culture with human pancreatic cancer cells and the cachexia-associated cytokines TNF-α and interleukin-6 in 3T3-L1 adipocytes. C26 colon carcinoma-bearing mice were modeled using CAC in vivo. Piceatannol reduced cancer-associated lipolysis by at least 50% in both CCM and cytokine-induced lipolysis in vitro. Further gene and protein analysis confirmed that piceatannol modulated the stability of lipolytic proteins. Moreover, piceatannol protected tumor-bearing mice against weight-loss in early stages of CAC largely through preserving adipose tissue, with no effect on survival. This study demonstrates the use of a dietary compound to preserve adipose in models of early stage CAC and provides groundwork for further investigation of piceatannol or piceatannol-rich foods as alternative medicine in the preservation of body fat mass and future CAC therapy.

Piceatannol antagonizes lipolysis by promoting autophagy-lysosome-dependent degradation of lipolytic protein clusters in adipocytes.

Overly elevated circulating non-esterified fatty acids (NEFAs) is an emerging health concern of obesity-associated energy disorders. However, methods to reduce circulating NEFAs remain elusive. The present study determined the effect of piceatannol, a naturally occurring stilbene, on adipocyte lipolysis and its underlying mechanism. Differentiated 3T3-L1 adipocytes, brown adipocytes and isolated white adipose tissue were treated with various concentrations of piceatannol for 1.5-h both in the basal and stimulated lipolysis conditions. Piceatannol significantly inhibited NEFAs and glycerol release with a concomitant reduction of ATGL, CGI-58 and PLIN1 expression in adipocytes. Using a series of inhibitor assays, piceatannol-induced degradation of these proteins was found to be mediated by upregulation of the autophagy-lysosome pathway. Moreover, we demonstrated that piceatannol is capable of stimulating autophagy in vitro. Importantly, piceatannol administration tended to lower fasting-induced serum glycerol levels in healthy mice. Furthermore, piceatannol administration lowered lipolysis, central adiposity and hyperinsulinemia in diet-induced obese mice. Our study provides profound evidence of a novel inhibitory role of piceatannol in lipolysis through autophagy-lysosome-dependent degradation of the key lipolytic proteins in adipocytes. This study offers a mechanistic foundation for investigating the potential of piceatannol-containing foods in reducing lipolysis and its associated metabolic disorders.

Health- or Environment-Focused Text Messages as a Potential Strategy to Increase Plant-Based Eating among Young Adults: An Exploratory Study.

Previous plant-based diet (PBD) adoption strategies have primarily focused on health rather than environmental rationale and meat reduction rather than plant-based protein promotion. In this study, we explored the effect of a theory-informed text-message intervention on dietary intentions and behaviors in young adult omnivores and the potential explanatory role of PBD beliefs, subjective norm, self-efficacy, moral norm, and health and environmental values. Participants completed baseline questionnaires and reported dietary intake before being randomly assigned to receive 2-3 health- or environment-focused text messages per week for eight weeks and then repeated baseline assessments. Although we did not see significant changes in meat or plant protein intake, we did observe a marked decrease in intentions to consume animal protein and a marginal increase in fruit and vegetable consumption intention. We identified subjective norms, self-efficacy, and moral satisfaction as the strongest predictors of changes in intention to consume animal or plant protein. Although few group differences were observed, those receiving environment-focused text messages experienced a greater change in values and were more likely to increase vegetable intake. Messages that improve sustainability awareness and provide practical adoption strategies may be part of an effective strategy to influence PBD intake among young adults.

Subtle sensory and labeling modifications have minimal impact on expected appetitive sensations in chewy bars.

Given the contribution of frequent hunger and overeating to the rising incidence of obesity, strategies to increase the satiating and satiety-inducing properties of snacks and meals are needed. In this study, we conducted three experiments to explore the contribution of sensory and labeling modifications to expected satiation and satiety in a popular and versatile snack: a chewy bar. For each experiment, we chose subtle interventions that could be incorporated into a variety of products without requiring significant reformulation. In experiment one, participants evaluated ten chewy bar samples (five flavors, two peanut form conditions) and rated five expected appetitive sensations. In experiment two, participants viewed one of six packaging images with various labeling interventions (control, protein bar label, "good for you" logo, meal bar label, calorie content logo, and "satisfies hunger longer" logo). The strongest sensory and labeling interventions from the first two experiments were combined and simultaneously evaluated in experiment three. Although we did not detect any significant effects of sensory or labeling modifications in any of the experiments, exploratory post-hoc analysis suggested that whole peanuts suppressed expected hunger and increased expected fullness, and that protein labeling increased expected satiety. Additionally, through a penalty-benefit analysis of check-all-that-apply (CATA) product characteristics, we identified several attributes that consumers may positively (wholesome, indulgent, sweet, heavy, rich) and negatively (processed) associate with expected appetitive sensations. Incorporation of sensory and packaging cues that elicit (or avoid, in the case of "processed") these attributes may aid in the creation of functional products to help manage appetite. Combining several intrinsic and extrinsic product modifications is likely necessary to meaningfully alter expected appetitive sensations.

Nutrition and taste and smell dysfunction.

Food selection plays a pivotal role in maintaining adequate nutrient intake, thus elucidating drivers of food choice is a meaningful strategy to maintain health and manage disease. Taste and smell are key determinants of food choice and warrant careful consideration. In this review, we first discuss how sensory stimulation influences food selection and metabolism. We then review the evidence regarding the relationship between taste and smell dysfunction and food preferences and selection, with attention given to contexts of certain chronic diseases. We conclude with brief recommendations for the management of chemosensory disorders. While sensory abilities influence food selection, the effect of taste and smell dysfunction on long-term consumption patterns and health status must be considered in light of environment, exposure, and culture.

Conditioning of human salivary flow using a visual cue for sour candy.

OBJECTIVE: Although the "mouthwatering" to sight, smell, or thought of food is commonly accepted in food and nutrition research, the concept of mouthwatering and human salivary flow conditioning is not well accepted in salivary research. The objective of this study was to revisit whether human salivary flow could be classically conditioned to a previously neutral stimulus. DESIGN: Sour candy or a non-food control in opaque containers were presented to healthy participants (n = 8). Simple images were consistently paired with container contents. Participants viewed the images for 15 s, then opened the containers and ate (candy) or did not eat (non-food control) the contents. This was repeated 14 times (7 of each stimulus). Order was semi-randomized to ensure one candy and one non-food were presented as the first two and last two stimuli. Saliva was collected with cotton dental rolls during these presentations (first two and last two) after viewing the image for 15 s, but before opening the container. RESULTS: Participants were successfully conditioned to increase salivary flow in response to the image that predicted candy, as demonstrated by greater weight of saliva in response to 1) the candy-paired image than the non-food-paired image, and 2) the candy-paired image at the end of the first visit compared with the beginning (when the image had no meaning). However, the effect was attenuated during the second visit. CONCLUSIONS: We demonstrate classical conditioning of human salivary flow is achievable, but the effect may not persist to a second visit.

Effects of conjugated linoleic acid (CLA) on fat accumulation, activity, and proteomics analysis in Caenorhabditis elegans.

Conjugated linoleic acid (CLA) has been reported to reduce fat storage in cell culture and animal models. In the current study, the effects of CLA on the fat accumulation, activities, and proteomics were investigated using Caenorhabditis elegans. 100 µM CLA-TG nanoemulsion significantly reduced fat accumulation by 29% compared to linoleic acid (LA)-TG treatment via sir-2.1 (the ortholog of Sirtuin 1), without altering the worm size, growth rate, and pumping rate of C. elegans. CLA significantly increased moving speed and amplitude (the average centroid displacement over the entire track) of wild type worms compared to the LA group and these effects were dependent on aak-2 (AMPKα ortholog) and sir-2.1. Proteomics analysis showed CLA treatment influences various proteins associated in reproduction and development, translation, metabolic processes, and catabolism and proteolysis, in C. elegans. We have also confirmed the proteomics data that CLA reduced the fat accumulation via abs-1 (ATP Synthase B homolog). However, there were no significant effects of CLA on brood size, progeny numbers, and hatchability compared to LA treatment.

The Therapeutic Potential of Piceatannol, a Natural Stilbene, in Metabolic Diseases: A Review.

Metabolic disease comprises a set of risk factors highly associated with obesity and insulin resistance and is a consequence of central adiposity, hyperglycemia, and dyslipidemia. Furthermore, obesity increases the risk of the development of metabolic disease due to ectopic fat deposition, low-grade inflammation, and systemic energy disorders caused by dysregulated adipose tissue function. Piceatannol is a naturally occurring polyphenolic stilbene found in various fruits and vegetables and has been reported to exhibit anticancer and anti-inflammatory properties. In addition, recently reported beneficial effects of piceatannol on hypercholesterolemia, atherosclerosis, and angiogenesis underscore its therapeutic potential in cardiovascular disease. However, investigation of its role in metabolic disease is still in its infancy. This review intensively summarizes in vitro and in vivo studies supporting the potential therapeutic effects of piceatannol in metabolic disease, including inhibition of adipogenesis and lipid metabolism in adipocytes, and regulation of hyperlipidemia, hyperglycemia, insulin resistance, and fatty acid-induced inflammation and oxidative stress.