Feasibility Study on the Use of NO2 and PM2.5 Sensors for Exposure Assessment and Indoor Source Apportionment at Fixed Locations.

Recent advances in sensor technology for air pollution monitoring open new possibilities in the field of environmental epidemiology. The low spatial resolution of fixed outdoor measurement stations and modelling uncertainties currently limit the understanding of personal exposure. In this context, air quality sensor systems (AQSSs) offer significant potential to enhance personal exposure assessment. A pilot study was conducted to investigate the feasibility of the NO2 sensor model B43F and the particulate matter (PM) sensor model OPC-R1, both from Alphasense (UK), for use in epidemiological studies. Seven patients with chronic obstructive pulmonary disease (COPD) or asthma had built-for-purpose sensor systems placed inside and outside of their homes at fixed locations for one month. Participants documented their indoor activities, presence in the house, window status, and symptom severity and performed a peak expiratory flow test. The potential inhaled doses of PM2.5 and NO2 were calculated using different data sources such as outdoor data from air quality monitoring stations, indoor data from AQSSs, and generic inhalation rates (IR) or activity-specific IR. Moreover, the relation between indoor and outdoor air quality obtained with AQSSs, an indoor source apportionment study, and an evaluation of the suitability of the AQSS data for studying the relationship between air quality and health were investigated. The results highlight the value of the sensor data and the importance of monitoring indoor air quality and activity patterns to avoid exposure misclassification. The use of AQSSs at fixed locations shows promise for larger-scale and/or long-term epidemiological studies.

Automatic Discrimination of Species within the Enterobacter cloacae Complex Using Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry and Supervised Algorithms.

The Enterobacter cloacae complex (ECC) encompasses heterogeneous clusters of species that have been associated with nosocomial outbreaks. These species may have different acquired antimicrobial resistance and virulence mechanisms, and their identification is challenging. This study aims to develop predictive models based on matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) profiles and machine learning for species-level identification. A total of 219 ECC and 118 Klebsiella aerogenes clinical isolates from three hospitals were included. The capability of the proposed method to differentiate the most common ECC species (Enterobacter asburiae, Enterobacter kobei, Enterobacter hormaechei, Enterobacter roggenkampii, Enterobacter ludwigii, and Enterobacter bugandensis) and K. aerogenes was demonstrated by applying unsupervised hierarchical clustering with principal-component analysis (PCA) preprocessing. We observed a distinctive clustering of E. hormaechei and K. aerogenes and a clear trend for the rest of the ECC species to be differentiated over the development data set. Thus, we developed supervised, nonlinear predictive models (support vector machine with radial basis function and random forest). The external validation of these models with protein spectra from two participating hospitals yielded 100% correct species-level assignment for E. asburiae, E. kobei, and E. roggenkampii and between 91.2% and 98.0% for the remaining ECC species; with data analyzed in the three participating centers, the accuracy was close to 100%. Similar results were obtained with the Mass Spectrometric Identification (MSI) database developed recently (https://msi.happy-dev.fr) except in the case of E. hormaechei, which was more accurately identified with the random forest algorithm. In short, MALDI-TOF MS combined with machine learning was demonstrated to be a rapid and accurate method for the differentiation of ECC species.

Calibration Method for Particulate Matter Low-Cost Sensors Used in Ambient Air Quality Monitoring and Research.

Over the last decade, manufacturers have come forth with cost-effective sensors for measuring ambient and indoor particulate matter concentration. What these sensors make up for in cost efficiency, they lack in reliability of the measured data due to their sensitivities to temperature and relative humidity. These weaknesses are especially evident when it comes to portable or mobile measurement setups. In recent years many studies have been conducted to assess the possibilities and limitations of these sensors, however mostly restricted to stationary measurements. This study reviews the published literature until 2020 on cost-effective sensors, summarizes the recommendations of experts in the field based on their experiences, and outlines the quantile-mapping methodology to calibrate low-cost sensors in mobile applications. Compared to the commonly used linear regression method, quantile mapping retains the spatial characteristics of the measurements, although a common correction factor cannot be determined. We conclude that quantile mapping can be a useful calibration methodology for mobile measurements given a well-elaborated measurement plan assures providing the necessary data.

Repeated antifungal use audits are essential for selecting the targets for intervention in antifungal stewardship.

A previous audit to assess the quality of antifungal use was performed in our hospital in 2011. After 5 years of antifungal stewardship program (AFS), we performed a follow-up audit in order to describe the long-term effect of such program. Using a predefined score, we evaluated the antifungal use in 100 consecutive adult inpatients receiving systemic antifungals. Results of the present audit were compared with those of a previous one, performed in 2011, before the implementation of our AFS. After 5 years, AFS program has induced a change in the population who received antifungal drugs in our hospital with a reduction in medical patients and a relative higher prescription among hematological ones. As for indications, empirical use decreased very significantly (from 62 to 30%, p < 0.001), while tailored treatment (from 20 to 41%, p = 0.001) and prophylaxis (from 15 to 27%, p = 0.03) increased. Compared to 2011, we also observed an improvement in the optimal choice of antifungal drug, route of administration, and microbiological adjustment. However, no significant improvement was observed regarding adequacy of length of therapy or optimal dosage or administration route. Although we observed an increase in the number of optimal DOTs used, the potential estimated savings continued to be high (~ €44,199 for every 100 patients receiving antifungals). Our study is the first to show the impact on the use of antifungal drugs exerted by a prolonged non-coercive AFS program. We also demonstrate the utility of a periodic audit of antifungal use in order to point out new goals for future interventions.

New Alternatives in Seafood Restructured Products.

A general overview, focusing on new trends in the different techniques used in restructured seafood product processing has been described in this work. Heat-induced gelation has been more widely studied in scientific literature than cold gelation technology. This latter technology includes the use of hydrocolloids (alginates and glucomannan) or enzymes (microbial transglutaminase) for making both raw and cooked restructured products. In restructuration processes, fortification processing with some functional ingredients is studied, giving as a result extra value to the products as well as increasing the variety of new seafood products. The process of alleviating heavy metals and organic pollutants from the raw material used has also been reviewed in the present paper.

Stabilized soy protein emulsion enriched with silicon and containing or not methylcellulose as novel technological alternatives to reduce animal fat digestion.

During the last decade, the consumption of animal saturated fat has been associated with an increased risk of chronic disease. Experience shows that changing the dietary habits of the population is a complicated and slow process, so technological strategies offer new possibilities for the development of functional foods. The present work is focused on studying the impact of using a food-grade non-ionic hydrocolloid (methylcellulose; MC) and/or the inclusion of silicon (Si) as a bioactive compound in pork lard emulsions stabilized with soy protein concentrate (SPC), on the structure, rheology, lipid digestibility and Si bioaccesibility during in vitro gastrointestinal digestion (GID). Four emulsions (SPC, SPC/Si, SPC/MC and SPC/MC/Si) were prepared with a final biopolymer (SPC and/or MC) concentration of 4% and 0.24% Si. The results showed a lower degree of lipid digestion in SPC/MC compared with SPC, specifically at the end of the intestinal phase. Moreover, Si partially reduced fat digestion only when incorporated into the SPC-stabilized emulsion, while this effect was lost in SPC/MC/Si. This was probably due to its retention inside the matrix emulsion, which resulted in lower bioaccesibility than in SPC/Si. Additionally, the correlation between the flow behavior index (n) and the lipid absorbable fraction was significant, suggesting that n can be a predictive marker of the extent of lipolysis. Concretely, our results revealed that SPC/Si and SPC/MC can be used as pork fat digestion reducers and thus, they can replace pork lard in the reformulation of animal products with potential health benefits.

Development and Physico-Chemical Characterization of Healthy Puff Pastry Margarines Made from Olive-Pomace Oil.

Due to its characteristic aroma and flavor, puff pastry (PP) prepared with butter is more accepted than that made with margarine, yet a high saturated fat consumption is associated with cardiovascular disease. This work studies the potential of olive-pomace oil (OPO) as main ingredient of PP margarines together with different organogelator agents to imitate the technological properties of a commercial fatty preparation (CFP). Rheological and textural properties were measured in all formulated margarines (FM) and, additionally, thermal and microstructural properties, and fatty acid (FA) profiles were analyzed in some selected FM. The different FM had viscous modulus (G″) and loss factor (tan δ) values lower than those of CFP, thus reflecting a different viscoelasticity and plasticity. The crystallization and melting temperatures of FM were also different from those of CFP, indicating the presence of a dissimilar polymorphic fat-crystal structure. Nevertheless, the FM containing an oleogel prepared with 5% beeswax and OPO was more similar to CFP. The FA profile of CFP and FM, with 80% polyunsaturated fatty acids (PUFA) and 60% oleic acid, is healthier than that of a PP commercial butter (CB), evidencing that, although improvements in margarine plasticity are still necessary, OPO is technologically viable to produce healthier PP margarines.

The Influence of Cellulose Ethers on the Physico-Chemical Properties, Structure and Lipid Digestibility of Animal Fat Emulsions Stabilized by Soy Protein.

This study explores the influence of carboxymethylcelullose (CMC) and methylcelullose (MC), added by simultaneous (sim) and sequential (seq) emulsification methods, on the structure, rheological parameters and in vitro lipid digestibility of pork lard O/W emulsions stabilized by soy protein concentrate (SPC). Five emulsions (SPC, SPC/CMC-sim, SPC/CMC-seq SPC/MC-sim, SPC/MC-seq) were prepared in vitro. The presence of CMC and MC, and the stage of incorporation affected the emulsion microstructure. In the SPC emulsion, lipid droplets were entrapped by a protein layer that was thicker when MC was added, providing greater resistance against environmental stresses during gastrointestinal digestion. At 37 °C, CMC incorporation produced a structural reinforcement of the SPC emulsion, whereas MC addition did not affect the network rigidity, although a delaying effect on the crossover temperature was observed, which was more evident in SPC/MC-seq. The presence and stage of CMC and MC incorporation affected the rate and extent of lipolysis, with SPC/MC-seq presenting an inferior concentration of free fatty acids. The lower extent of lipolysis observed in SPC/MC-seq may be positive in the manufacture of animal fat products in which reduced fatty acid absorption is intended.

Effects of Magnetic Fields on Freezing: Application to Biological Products.

Magnetic freezing is nowadays established as a commercial reality mainly oriented towards the food market. According to advertisements, magnetic freezing is able to generate tiny ice crystals throughout the frozen product, prevent cell destruction, and preserve the quality of fresh food intact after thawing. If all these advantages were true, magnetic freezing would represent a significant advance in freezing technology, not only for food preservation, but also for cryopreservation of biological specimens such as cells, tissues, and organs. Magnetic fields (MFs) are supposed to act directly on water by orientating, vibrating, and/or spinning molecules to prevent them from clustering and, thus, to promote supercooling. However, many doubts exist about the real effects of MFs on freezing and the science behind the potential mechanisms involved. To provide a basis for extending the understanding of magnetic freezing, this paper presents a critical review of the materials published in the literature up to now, including both patents and experimental results. After examining the information available, it was not possible to discern whether MFs have an appreciable effect on supercooling, freezing kinetics, ice crystals, quality, and/or viability of the frozen products. Experiments described in the literature frequently fail to identify and/or control all the factors that can play a role in magnetic freezing. Moreover, many of the comparisons between magnetic and conventional freezing are not correctly designed to draw valid conclusions, and wide ranges of MF intensities and frequencies are unexplored. Therefore, more rigorous experimentation and further evidence are needed to confirm or reject the efficacy of MFs in improving the quality of frozen products.

Emergence and Persistence over Time of Carbapenemase-Producing Enterobacter Isolates in a Spanish University Hospital in Madrid, Spain (2005-2018).

Carbapenemase production is constantly increasing among different Enterobacterales species. We analyzed the microbiological characteristics and population structure of all carbapenemase-producing Enterobacter spp. (CP-Ent) isolates recovered at the Ramón y Cajal Hospital between 2005 and 2018. Overall, 178 CP-Ent isolates (60.7% colonization, 39.3% clinical) were recovered from 165 hospitalized patients (165/176, 93.7%; medical [102/165], surgical [34/165], and intensive care unit [29/165] areas), emergency unit (4/176, 2.3%), and ambulatory patients (7/176, 4.0%). In addition, three CP-Ent were found in environmental sources. Clinical samples were mainly urine (37.1%). The most frequent matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF)-identified species were Enterobacter cloacae (n = 85) and Enterobacter asburiae (n = 49). hsp60 gene sequencing showed a higher species diversity than MALDI-TOF: 70 Enterobacter hormaechei-clusters III, VI, VIII; 69 Enterobacter roggenkampii-IV; 15 Enterobacter kobei-II; 9 E. asburiae-I; 3 Enterobacter ludwigii-V; and 1 E. cloacae subsp. dissolvens-XII. Nine Klebsiella aerogenes were also identified. Overall, a high clonal diversity (Simpson Diversity Index >0.90) was found among CP-Ent-clusters. Environmental isolates were clonally related to clinical ones. Amikacin and tigecycline showed the highest susceptibility (>93%). VIM-1 (n = 133/181, 73.5%) and OXA-48 (n = 34/181, 18.8%) carbapenemases were predominant, followed by KPC-2 (n = 9/181, 5.0%), KPC-3 (n = 2/181, 1.1%), VIM-2 (n = 1/181, 0.6%), and two coproducers (VIM-1+KPC-2 and VIM-1+KPC-3). Extended-spectrum beta-lactamase (ESBL) coproduction (14.4%) emerged in 2012, mainly associated with blaSHV-12 (p < 0.001), E. roggenkampii (p < 0.001), and colonization (p = 0.03). VIM-1- and OXA-48-CP-Ent fecal carriers increased in our hospital, particularly between 2011 and 2018 (p < 0.001). Moreover, KPC and OXA-48 producers emerged in 2010 and 2012, respectively. They superimposed over VIM producers, which were persistently recovered since first detection in 2005. These results depict increased complexity over time of CP-Ent.

Therapeutic Drug Monitoring of Antifungal Drugs: Another Tool to Improve Patient Outcome?

INTRODUCTION: This study aimed to examine the relationship among adequate dose, serum concentration and clinical outcome in a non-selected group of hospitalized patients receiving antifungals. METHODS: Prospective cross-sectional study performed between March 2015 and June 2015. Dosage of antifungals was considered adequate according to the IDSA guidelines, whereas trough serum concentrations (determined with HPLC) were considered adequate as follows: fluconazole > 11 µg/ml, echinocandins > 1 µg/ml, voriconazole 1-5.5 µg/ml and posaconazole > 0.7 µg/ml. RESULTS: During the study period, 84 patients (65.4% male, 59.6 years) received antifungals for prophylaxis (40.4%), targeted (31.0%) and empirical therapy (28.6%). The most frequent drug was micafungin (28/84; 33.3%) followed by fluconazole (23/84; 27.4%), voriconazole (15/84; 17.9%), anidulafungin (8/84; 9.5%), posaconazole (7/84; 8.3%) and caspofungin (3/84; 3.6%). Considerable interindividual variability was observed for all antifungals with a large proportion of the patients (64.3%) not attaining adequate trough serum concentrations, despite receiving an adequate antifungal dose. Attaining the on-target serum antifungal level was significantly associated with a favorable clinical outcome (OR = 0.02; 95% CI 0.01-0.64; p = 0.03), whereas the administration of an adequate antifungal dosage was not. CONCLUSIONS: With the standard antifungal dosage, a considerable proportion of patients have low drug concentrations, which are associated with poor clinical outcome.

Stability of omega-3 fatty acids in fortified surimi seafoods during chilled storage.

Physical, chemical, and sensory properties of cooked surimi seafood gels (crab analogue) fortified with omega-3 fatty acids (FA) were monitored during chilled storage. Three sources of stabilized omega-3 FA (fish oil concentrate, menhaden oil, and a purified marine oil) were each incorporated into gels to an omega-3 FA content of 1.5 or 2.5%, w/w. Omega-3 FA stability, development of off-flavors, and changes in color and texture were monitored during chilled storage for 2 months. Gels with fish oil concentrate developed fishy flavor and aroma within 30 days and were eliminated from the study. Gels containing menhaden oil and purified marine oil exhibited little change in sensory properties or oxidation products throughout 2 months of storage. Relative polyene index values (ratio of polyunsaturated to saturated fatty acids) indicated that the omega-3 FA were stable at both levels of addition. Omega-3 fortified gels were whiter than control gels, and gel texture was modified when menhaden and purified oils were added but not significantly affected by the level of omega-3 addition.

Vitamin C content and sensorial properties of dehydrated carrots blanched conventionally or by ultrasound.

Vitamin C content and sensorial properties have been evaluated in air-dried carrots previously subjected to different ultrasound (US) or conventional blanching pretreatments. In addition, mass spectral fingerprints obtained by the Headspace ChemSensor System have been evaluated for the first time for classification of carrots according to their processing. Conventional blanching treatments at high temperature gave rise to carrots with retention of vitamin C in the range 37.5-85%, whereas carrots blanched conventionally at 60°C and by US-probe at temperatures up to 60 and 70°C showed vitamin C retention values lower than 4%. Regarding sensorial analysis of rehydrated carrots, US-pretreated samples presented acceptable quality, and no statistically significant differences with respect to conventionally blanched carrots, were detected. In spite of this, differentiation of samples processed under comparable intensity conditions and/or with similar composition was possible from their mass spectral fingerprints after chemometric data analysis.