Low-intensity pulsed electric field processing prior to germination improves in vitro digestibility of faba bean (Vicia faba L.) flour and its derived products: A case study on legume-enriched wheat bread.

This study investigated the effect of low-intensity pulsed electric field (PEF) (0.3-0.7 kV/cm) and/or germination (0-72 h, 20 °C) on faba beans prior to flour- and breadmaking. PEF (0.5 and 0.7 kV/cm) had no significant effect on the germination performance of faba bean but had a positive effect on in vitro starch and protein hydrolysis of PEF-treated beans germinated for 72 h. The incorporation of flour from soaked, germinated, PEF-treated, and PEF-treated+germinated faba beans into wheat bread, at 30% mass level, improved the nutritional composition (total starch and protein contents) and protein digestibility but it reduced the specific volume and increased the density, brownness, and hardness of the bread. This finding shows for the first time that PEF-treatment (<0.7 kV/cm) of faba beans followed by germination (72 h) improved in vitro starch and protein hydrolysis of its flour and the protein digestibility at gastric phase of its enriched wheat bread.

In vitro digestion properties and use of automatic image analysis to assess the quality of wheat bread enriched with whole faba bean (Vicia faba L.) flour and its protein-rich fraction.

The trend of incorporating faba bean (Vicia faba L.) in breadmaking has been increasing, but its application is still facing technological difficulties. The objective of this study was to understand the influence of substituting the wheat flour (WF) with 10, 20, 30 and 40 % mass of whole bean flour (FBF) or 10 and 20 % mass of faba bean protein-rich fraction (FBPI) on the quality (volume, specific volume, density, colour, and texture), nutritional composition (total starch, free glucose, and protein contents), and kinetics of in vitro starch and protein digestibility (IVSD and IVPD, respectively) of the breads. Automated image analysis algorithm was developed to quantitatively estimate the changes in the crumb (i.e., air pockets) and crust (i.e., thickness) due to the use of FBF or FBPI as part of the partial substitution of wheat flour. Higher levels of both FBF and FBPI substitution were associated with breads having significant (p < 0.05) lower (specific) volume (at least 25 % reduction) and higher density (up to 35 %), increased brownness (up to 49 % and 78 % for crust and crumb respectively), and up to 2.3-fold increase in hardness. Result from the image analysis has provided useful insights on how FBF and FBPI affecting bread characteristics during baking such as loss of crumb expansion, decrease in air pocket expansion and increase in crust thickness. Overall, incorporation of FBF or FBPI in wheat bread were favourable in reducing the starch content and improving the protein content and IVPD of wheat bread. Since bread remains as a staple food due to its convenience, versatility and affordability for individuals and families on a budget, wheat bread enriched with faba bean could be a perfect food matrix to increase daily protein intake.

Documented ß-Lactam Allergy and Risk for Cesarean Surgical Site Infection.

Objective: To examine the relationship between documented ß-lactam allergy and cesarean delivery (CD) surgical site infection (SSI). Study Design. We conducted a retrospective cohort analysis of women who underwent CD at Ben Taub Hospital and Texas Children's Pavilion for Women (Houston, TX) from August 1, 2011, to December 31, 2019. The primary exposure was a documented ß-lactam allergy, and the second exposure of interest was the type of perioperative antibiotic received. The primary outcome was the prevalence of SSI. Maternal characteristics were stratified by the presence or absence of a documented ß-lactam allergy, and significance was evaluated using Pearson's chi-squared test for categorical variables and t-test for continuous variables. A logistic regression model estimated odds of SSI after adjusting for possible confounders. Results: Of the 12,954 women included, 929 (7.2%) had a documented ß-lactam allergy while 12,025 (92.8%) did not. Among the 929 women with a ß-lactam allergy, 495 (53.3%) received non-ß-lactam perioperative prophylaxis. SSI occurred in 38 (4.1%) of women who had a ß-lactam allergy versus 238 (2.0%) who did not (p ≤ 0.001). ß-Lactam allergy was associated with higher odds of SSI compared to no allergy (adjusted odds ratio (aOR) = 1.97; 95%confidence interval (CI) = 1.24-3.14; p = 0.004) after controlling for age, race, ethnicity, insurance status, delivery body mass index (BMI), tobacco use, intra-amniotic infection in labor, duration of membrane rupture, preterm delivery, delivery indication, diabetes, hypertension, group B Streptococcus colonization, and type of perioperative antibiotic received. Conclusion: The presence of a ß-lactam allergy is associated with increased odds of developing a CD SSI after controlling for possible confounders, including the type of perioperative antibiotic received.

Designing Technology to Decrease Pneumonia in Intubated Trauma Patients.

Trauma patients are at increased risk for developing ventilator-associated pneumonia. Sixty adult trauma intensive care unit patients were audited 3 months prepractice change, and 30 were audited postpractice change. Quality improvement interventions included staff education of a redesigned electronic medical record ventilator bundle and chlorhexidine gluconate administration timing practice change. Postpractice change audits revealed 2-hour chlorhexidine gluconate documentation increased from 38.3% to 73.3% and incidence of pneumonia in intubated patients decreased by 62%. Early initiation of chlorhexidine gluconate mouth care utilizing electronic medical record technology may help reduce pneumonia in intubated patients, hospital length of stay, overall health costs, and improve documentation.