Determinants of the optimal selection of vascular access devices: A systematic review underpinned by the COM-B behavioural model.

BACKGROUND: Optimal selection of vascular access devices is based on multiple factors and is the first strategy to reduce vascular access device-related complications. This process is dependent on behavioural and human factors. The COM-B (Capability, Opportunity, Motivation, Behaviour) model was used as a theoretical framework to organize the findings of this systematic review. METHODS/AIMS: To synthesize the evidence on determinants shaping the optimal selection of vascular access devices, using the COM-B behavioural model as the theoretical framework. DESIGN: Systematic review of studies which explore decision-making at the time of selecting vascular access devices. DATA SOURCES: The Medline, Web of Science, Scopus and EbscoHost databases were interrogated to extract manuscripts published up to 31 December 2021, in English or Spanish. RESULTS: Among 16 studies included in the review, 8/16 (50%) focused on physical capability, 8/16 (50%) psychological capability, 15/16 (94%) physical opportunity, 12/16 (75%) social opportunity, 1/16 (6%) reflective motivation and 0/16 (0%) automatic motivation. This distribution represents a large gap in terms of interpersonal and motivational influences and cultural and social environments. Specialist teams (teams created for the insertion or maintenance of vascular access devices) are core for the optimal selection of vascular access devices (75% physical capability, 62% psychological capability, 80% physical opportunity and 100% social opportunity). CONCLUSION: Specialist teams predominantly lead all actions undertaken towards the optimal selection of vascular access devices. These actions primarily centre on assessing opportunity and capability, often overlooking motivational influences and social environments. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: A more implementation-focused professional approach could decrease inequity among patients and complications associated with vascular access devices. IMPACT: Optimal selection of vascular access devices is the primary strategy in mitigating complications associated with these devices. There is a significant disparity between interpersonal and motivational influences and the cultural and social environments. Furthermore, specialized teams play a pivotal role in facilitating the optimal selection of vascular access devices. The study can benefit institutions concerned about vascular access devices and their complications. REPORTING METHOD: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. WHAT DOES THIS ARTICLE CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Optimal selection of vascular devices remains a growing yet unresolved issue with costly clinical and patient experience impact. Interventions to improve the optimal selection of vascular devices have focused on training, education, algorithms and implementation of specialist vascular teams; alas, these approaches do not seem to have substantially addressed the problem. Specialist vascular teams should evolve and pivot towards leading the implementation of quality improvement interventions, optimizing resource use and enhancing their role.

Singlet Oxygen Detection by Chemiluminescence Probes in Living Cells.

Singlet oxygen is a reactive oxygen species that causes oxidative damage to plant cells, but intriguingly it can also act as a signalling molecule to reprogram gene expression required to induce plant physiological/cellular responses. Singlet oxygen photosensitization in plants mainly occurs in chloroplasts after the molecular collision of ground-state molecular oxygen with triplet-excited-state chlorophyll. Singlet oxygen direct detection through phosphorescence emission in chloroplasts is a herculean task due to its extremely low luminescence quantum yield. Because of this, indirect alternative methods have been developed for its detection in biological systems, for example, by measuring the changes in the EPR signal or fluorescence intensity of singlet oxygen reaction-based probes. The singlet oxygen chemiluminescence (SOCL) is a chemiluminescence probe with high sensitivity and selectivity towards singlet oxygen and promising use to detect it in living cells without the inconvenience of low stability of the EPR signal of spin probes in the presence of redox compounds, spurious light scattering coming from the light source required for the excitation of fluorescence probes or the light emission of endogenous fluorescent molecules like chlorophyll in chloroplasts. The protocol presented in this chapter describes the first steps to characterizing singlet oxygen production within the biological system under study; this is accomplished through monitoring molecular oxygen consumption by SOCL using a Clark-type oxygen electrode and measuring the chemiluminescence generated by SOCL 1,2-dioxetane using a spectrofluorometer. For singlet oxygen detection within living cells, a version of SOCL with increased membrane permeability (SOCL-CPP) is described.

Electronic Prediction of Chemical Contaminants in Aroma of Brewed Roasted Coffee and Quantification of Acrylamide Levels.

The aim of this research was to apply an electronic device as indirect predictive technology to evaluate toxic chemical compounds in roasted espresso coffee. Fresh coffee beans were subjected to different thermal treatments and analyzed to determine volatile organic compounds, content of acrylamide and 5-hydroxymethylfurfural, sensory characteristics and electronic nose data. In total, 70 different volatile compounds were detected and grouped into 15 chemical families. The greatest percentage of these compounds were furans, pyrazines, pyridines and aldehydes. The positive aroma detected had the intensity of coffee odor and a roasted aroma, whereas the negative aroma was related to a burnt smell. A linear relationship between the toxic substances and the sensory defect was established. A high sensory defect implied a lower content of acrylamide and a higher content of 5-hydroxymethylfurfural. Finally, electronic signals were also correlated with the sensory defect. This relationship allowed us to predict the presence of these contaminants in the roasted coffee beverage with an indirect method by using this electronic device. Thus, this device may be useful to indirectly evaluate the chemical contaminants in coffee beverages according to their sensory characteristics.

Mediterranean Shrub Species as a Source of Biomolecules against Neurodegenerative Diseases.

Neurodegenerative diseases are associated with oxidative stress, due to an imbalance in the oxidation-reduction reactions at the cellular level. Various treatments are available to treat these diseases, although they often do not cure them and have many adverse effects. Therefore, it is necessary to find complementary and/or alternative drugs that replace current treatments with fewer side effects. It has been demonstrated that natural products derived from plants, specifically phenolic compounds, have a great capacity to suppress oxidative stress and neutralize free radicals thus, they may be used as alternative alternative pharmacological treatments for pathological conditions associated with an increase in oxidative stress. The plant species that dominate the Mediterranean ecosystems are characterized by having a wide variety of phenolic compound content. Therefore, these species might be important sources of neuroprotective biomolecules. To evaluate this potential, 24 typical plant species of the Mediterranean ecosystems were selected, identifying the most important compounds present in them. This set of plant species provides a total of 403 different compounds. Of these compounds, 35.7% are phenolic acids and 55.6% are flavonoids. The most relevant of these compounds are gallic, vanillic, caffeic, chlorogenic, p-coumaric, and ferulic acids, apigenin, kaempferol, myricitrin, quercetin, isoquercetin, quercetrin, rutin, catechin and epicatechin, which are widely distributed among the analyzed plant species (in over 10 species) and which have been involved in the literature in the prevention of different neurodegenerative pathologies. It is also important to mention that three of these plant species, Pistacea lentiscus, Lavandula stoechas and Thymus vulgaris, have most of the described compounds with protective properties against neurodegenerative diseases. The present work shows that the plant species that dominate the studied geographic area can provide an important source of phenolic compounds for the pharmacological and biotechnological industry to prepare extracts or isolated compounds for therapy against neurodegenerative diseases.

Influences of Yogurt with Functional Ingredients from Various Sources That Help Treat Leaky Gut on Intestinal Barrier Dysfunction in Caco-2 Cells.

The impact of yogurts made with starter culture bacteria (L. bulgaricus and S. thermophilus) and supplemented with ingredients (maitake mushrooms, quercetin, L-glutamine, slippery elm bark, licorice root, N-acetyl-D-glucosamine, zinc orotate, and marshmallow root) that can help treat leaky gut were investigated using the Caco-2 cell monolayer as a measure of intestinal barrier dysfunction. Milk from the same source was equally dispersed into nine pails, and the eight ingredients were randomly allocated to the eight pails. The control had no ingredients. The Caco-2 cells were treated with isoflavone genistein (negative control) and growth media (positive control). Inflammation was stimulated using an inflammatory cocktail of cytokines (interferon-γ, tumor necrosis factor-α, and interleukin-1ß) and lipopolysaccharide. The yogurt without ingredients (control yogurt) was compared to the yogurt treatments (yogurts with ingredients) that help treat leaky gut. Transepithelial electrical resistance (TEER) and paracellular permeability were measured to evaluate the integrity of the Caco-2 monolayer. Transmission electron microscopy (TEM), immunofluorescence microscopy (IM), and real-time quantitative polymerase chain reaction (RTQPCR) were applied to measure the integrity of tight junction proteins. The yogurts were subjected to gastric and intestinal digestion, and TEER was recorded. Ferrous ion chelating activity, ferric reducing potential, and DPPH radical scavenging were also examined to determine the yogurts' antioxidant capacity. Yogurt with quercetin and marshmallow root improved the antioxidant activity and TEER and had the lowest permeability in fluorescein isothiocyanate (FITC)-dextran and Lucifer yellow flux among the yogurt samples. TEM, IM, and RTQPCR revealed that yogurt enhanced tight junction proteins' localization and gene expression. Intestinal digestion of the yogurt negatively impacted inflammation-induced Caco-2 barrier dysfunction, while yogurt with quercetin, marshmallow root, maitake mushroom, and licorice root had the highest TEER values compared to the control yogurt. Yogurt fortification with quercetin, marshmallow root, maitake mushroom, and licorice root may improve functionality when dealing with intestinal barrier dysfunction.

Interventions to reduce peripheral intravenous catheter failure: An international e-Delphi consensus on relevance and feasibility of implementation.

BACKGROUND: Around 1 billion peripheral intravenous catheters (PIVC) fail annually worldwide before prescribed intravenous therapy is completed, resulting in avoidable complications, dissatisfaction, and avoidable costs surging to ∼€4bn. We aimed to provide an international consensus on relevance and feasibility of clinical practice guideline recommendations to reduce PIVC failure. METHODS: e-Delphi study with three rounds through an online questionnaire from March-September 2020 recruiting a multispecialty panel formed by clinicians, managers, academic researchers, and experts in implementation from seven developed and three developing countries, reflecting on experience in PIVC care and implementation of evidence. Further, we included a panel of chronic patients with previous experience in the insert, maintenance, and management of PIVC and intravenous therapy from Ireland and Spain as public and patient involvement (PPI) panel. All experts and patients scored each item on a 4-point Likert scale to assess the relevance and feasibility. We considered consensus descriptor in which the median was 4 with less than or equal to 1,5 interquartile intervals. FINDINGS: Over 90% participants (16 experts) completed the questionnaire on all rounds and 100% PPI (5 patients) completed round 1 due to high consensus they achieved. Our Delphi approach included 49 descriptors, which resulted in an agreed 30 across six domains emerged from the related to (i) general asepsis and cutaneous antisepsis (n = 4), (ii) catheter adequacy and insertion (n = 3), (iii) catheter and catheter site care (n = 6), (iv) catheter removal and replacement strategies (n = 4), (v) general principles for catheter management (n = 10), and (vi) organisational environment (n = 3). CONCLUSION: We provide an international consensus of relevant recommendations for PIVC, deemed feasible to implement in clinical settings. In addition, this methodological approach included substantial representation from clinical experts, academic experts, patient and public expertise, mitigating uncertainty during the implementation process with high-value recommendations to prevent PIVC failure based contextual and individual features, and economic resources worldwide.

Assessment of Luteal Function Using Rectal Palpation, B-Mode Ultrasonography, and Progesterone Determination to Improve Recipient Selection in Embryo Transfer Programs.

Proper selection of recipients determines the success of embryo transfer (ET) programs. Therefore, the objectives of this study were to assess the accuracy of rectal palpation (RP) in selecting recipients according to the size and firmness of their corpus luteum (CL) compared to ultrasonography (US) and progesterone determination (P4); to check if US or P4 provide additional information to RP with regard to selecting animals with higher odds of maintaining the pregnancy; and to verify the reliability of the presence of a cavity and the volume of the CL within the ovary (%CLOV) as predictors of the ET outcome. In Experiment 1, measurements for the largest and minor diameter (LADCL and MIDCL), CL area, and P4 at ET day were collected, as well as the RP score, in 94 heifers. In Experiment 2, measurements for the LADCL, MIDCL, CL volume, %CLOV, and presence of a cavity were collected, as well as data about the procedure and metabolic markers, in 108 heifers. No differences were found in Experiment 1, whereas in Experiment 2, just a tendency was observed for the variable of veterinarian. Consequently, these results suggest that RP and US are useful methods to select recipients with, that US and P4 do not offer additional data to use to select animals with higher odds of maintaining pregnancy, and that neither %CLOV nor cavitary CL were good indicators for pregnancy rates.

Isolated Fraction of Gastric-Digested Camel Milk Yogurt with Carao (Cassia grandis) Pulp Fortification Enhances the Anti-Inflammatory Properties of HT-29 Human Intestinal Epithelial Cells.

Functional foods have recently generated a lot of attention among consumers looking for healthy options. Studies have examined yogurt with carao to increase health benefits and probiotic characteristics. It has been determined that carao fruit and camel milk have high phenolic compound and antioxidant activity concentrations. The objective of this study was to examine if carao (0, 1.3, 2.65, and 5.3 g/L) incorporated into yogurt enhances anti-inflammatory stimulus and antioxidant activity and impacts the physio-chemical and sensory properties of camel milk yogurt. HT-29 cells were used as a model of anti-inflammatory response, including cytokine responses of IL-8 and mRNA production of IL-1ß and TNF-α in gastric digested isolated fraction. In addition, pH, titratable acidity, Streptococcus thermophilus counts and Lactobacillus bulgaricus counts of camel yogurts were examined during the fermentation process in 0, 2.5, 5, and 7 h whereas viscosity, syneresis, and radical scavenging assay evaluations were determined at hour 7. Furthermore, a consumer study was performed. Compared to control samples, the incorporation of carao into yogurts did not lead to a significant (ρ > 0.05) difference in the pH. In contrast, titratable acidity (TA), viscosity, syneresis, and antioxidant capacity significantly increased with the inclusion of 2.65 and 5.3 g/L carao, while 5.3 g/L carao significantly (ρ < 0.05) increased the counts of both bacteria. The inflammatory response of IL-8 and the level of mRNA production of IL-1ß and TNF-α was significantly (ρ < 0.05) lower with 2.65 and 5.3 g/L carao yogurt compared to control camel yogurt. Sensory attributes were not impacted by the addition of 1.3 and 2.65 g/L carao. Carao could be a possible ingredient to consider when improving the nutrition value of yogurt.

Effect of Microwave and Ultrasound-Assisted Extraction on the Phytochemical and In Vitro Biological Properties of Willow (Salix alba) Bark Aqueous and Ethanolic Extracts.

White willow (Salix alba) is a medicinal plant used in folk medicine. In this study, aqueous and ethanolic willow bark extracts were obtained via ultrasonic-assisted extraction (UAE) and microwave-assisted extraction (MAE), and analyzed regarding their phytochemical (total phenolics, phenolic acids, flavonoids, and tannins) content and in vitro biological properties (antibacterial and antifungal activity, acetylcholinesterase AChE inhibitory activity and anti-inflammatory effects). The highest phenolic, tannin, and flavonoid contents were found for willow bark extracts obtained via microwave-assisted extraction using ethanol as a solvent (SA-ME). The polyphenol load of all MAE and UAE extracts was higher when conventional solid-liquid extraction was applied (ρ < 0.05). The antioxidant capacities were stronger for microwave-assisted ethanolic extracts, with the lowest IC50 values of 12 µg/mL for DPPH• and a value of 16 µg/mL for ABTS•+, whereas the conventional extraction had the highest IC50 values (22 µg/mL and 28 µg/mL, respectively). Willow bark extract showed antibacterial activity against Gram-positive bacteria S. aureus and P. aeruginosa. AChE inhibitory activity was dependent on the extraction method and solvent used, and the highest inhibition among samples was observed for SA-ME. Taken altogether, our findings suggest that willow (Salix alba) bark extract obtained via ethanolic microwave-assisted extraction is a phytochemical-rich resource with in vitro, anti-inflammatory, and AchE inhibitory properties and, therefore, potential multiple medicinal end-uses.

Burn Defect and Phenol Prediction for Flavoured Californian-Style Black Olives Using Digital Sensors.

Californian-style black olives can undergo different chemical changes during the sterilization process that can affect their sensory and phenol characteristics. Thus, these olives were stuffed with flavoured hydrocolloids and submitted to different thermal sterilization treatments to assess sensory categories. The triangular test indicated that the panellists were able to discriminate between samples from different categories according to their aromas with more than 85% success. The results indicated that the negative aroma detected by tasters was related to burn defects. The highest level of defects was found in standard olives, while the lowest was identified in the extra category. Furthermore, olives submitted to the lowest thermal sterilization treatment (extra) presented significantly higher phenol profile content, such as for hydroxytyrosol, tyrosol, oleuropein and procyanidin B1. The electronic nose (E-nose) discriminated between samples from different categories according to the specific aroma (PC1 = 82.1% and PC2 = 15.1%). The PLS-DA classified the samples with 90.9% accuracy. Furthermore, the volatile organic compounds responsible for this discrimination were creosol, copaene, benzaldehyde and diallyl disulphide. Finally, the models established by the PLS analysis indicated that the E-nose could predict olives according to their aroma and total phenol profile (RCV2 values were 0.89 and 0.92, respectively). Thus, this device could be used at the industrial level to discriminate between olives with different sensory aromas to determine those with the highest quality.

Sous-vide processing of silver carp: Effect of processing temperature and cold storage duration on the microbial quality of the product as well as modeling by artificial neural networks.

Silver carp (Hypophthalmichthys molitrixi) was processed by sous-vide method at different temperatures (60, 65, 70, and 75°C). Then, the microbiological quality of the processed samples was monitored during cold storage (4°C) for 21 days. The target microorganisms were Enterobacteriaceae, Lactic Acid bacteria (LAB), Pseudomonas, Psychrotrophs, and total viable count (TVC). In samples processed at 75°C, the presence of Enterobacteriaceae, Pseudomonas and Psychrotrophs were not detectable up to 15 days of storage and lactic acid bacteria were not detectable even at the end of the storage period. A radial basis function neural network (RBFNN) model was established to predict the changes in the microbial content of silver carp. In this step, the relationship between processing temperature and storage duration on microbial growth was modeled by ANNs (artificial neural networks). The optimal ANN topology for modeling Enterobacteriaceae, Pseudomonas, and Psychrotroph contained 9 neurons in the hidden layer, but it contained 15 and 14 neurons for TVC and LAB, respectively. By experimenting with the temperature of -80°C, it was revealed that the obtained ANN model has a high potential for prediction.

Evaluation of Tunisian Olive Leaf Extracts to Reduce the Bioavailability of Acrylamide in Californian-Style Black Olives.

The aim of this work was analyzing the use of olive leaf extracts (OLE) obtained from two local Tunisian olive tree cultivars 'Chemlali' and 'Sayali' to reduce the acrylamide in Californian-style black olives. The phenol profile, antioxidant, and antibacterial activity of the two OLE extracts were evaluated. The principal phenols found were hydroxytyrosol (1809.6 ± 25.3 mg 100 g-1), oleuropein (2662.2 ± 38 mg 100 g-1) and luteolin-7-O-glucoside (438.4 ± 38 mg 100 g-1) presented higher levels in 'Sayali' variety. Small differences were observed between the two kinds of extracts used; the greatest activity of OLE was observed against S. choleraesuis, with values up to 50% inhibition. The extract of 'Chemlali' cultivar was added to the Californian-style table olive, improving its phenol content and its antioxidant characteristics without negatively affecting its sensorial characteristics; these olives showed the highest firmness and proper quality characteristics. The gastrointestinal activity on the acrylamide concentration showed a partial degradation of this compound through the digestion, although the addition of the extract does not seem influence in its gastrointestinal digestion. These findings prove the usefulness of by-products to generate a high-quality added-value product, and this would also be relevant as a step towards a more sustainable, circular economy model.

Novel Liquor-Based Hot Sauce: Physicochemical Attributes, Volatile Compounds, Sensory Evaluation, Consumer Perception, Emotions, and Purchase Intent.

Hot sauces are popular peppery condiments used to add flavor and sensory excitement to gastronomical preparations. While hot sauce occupies a retail category well over a century old, a novel production method using liquor as the base preservative rather than traditional vinegar is now commercially available, and its uniqueness begs study. Hot sauces produced with tequila, rum, vodka, and bourbon were compared to traditional vinegar-based hot sauces concerning physicochemical properties, volatile compounds, microbiological quality, sensory scores, emotions, and purchase intent (PI). Under accelerated conditions, pH, titratable acidity (TA), water activity (Aw), viscosity, and color were analyzed weekly for 20 weeks, whereas rheological properties, coliforms and yeasts and molds were examined on weeks 1 and 20. Hexyl n-valerate, butanoic acid, 3-methyl-, hexyl ester, and 4-methylpentyl 3-methylbutanoate were found in high concentrations in the pepper mix as well as the hot sauce produced with vinegar. When compared to vinegar-based hot sauces, liquor-based hot sauces had similar Aw (p > 0.05), higher pH, viscosity, and L* values and lower TA, a*, and b* values (p < 0.05). Samples formulated with liquors increased the relaxation exponent derived from G' values having a greater paste formation when compared to vinegar-based hot sauces. The sensory evaluation was carried out in Honduras. The liquor-based hot sauces had a significant (p < 0.05) impact on emotion and wellness terms. Bourbon and tequila samples had higher ratings than control samples in several wellness and emotion responses (active, energetic, enthusiastic, good, curious, pleased, stimulated, and wild). Adventurous, joyful, free, worried, refreshed, and healthy scores were not significantly (p > 0.05) different among treatments.

Electronic Nose and Gas Chromatograph Devices for the Evaluation of the Sensory Quality of Green Coffee Beans.

The aim of this work is to discriminate between the volatile org9anic compound (VOC) characteristics of different qualities of green coffee beans (Coffea arabica) using two analysis approaches to classify the fresh product. High-quality coffee presented the highest values for positive attributes, the highest of which being fruity, herbal, and sweet. Low-quality samples showed negative attributes related to roasted, smoky, and abnormal fermentation. Alcohols and aromatic compounds were most abundant in the high-quality samples, while carboxylic acids, pyrazines, and pyridines were most abundant in the samples of low quality. The VOCs with positive attributes were phenylethyl alcohol, nonanal and 2-methyl-propanoic acid, and octyl ester, while those with negative attributes were pyridine, octanoic acid, and dimethyl sulfide. The aroma quality of fresh coffee beans was also discriminated using E-nose instruments. The PLS-DA model obtained from the E-nose data was able to classify the different qualities of green coffee beans and explained 96.9% of the total variance. A PLS chemometric approach was evaluated for quantifying the fruity aroma of the green coffee beans, obtaining an RP2 of 0.88. Thus, it can be concluded that the E-nose represents an accurate, inexpensive, and non-destructive device for discriminating between different coffee qualities during processing.

Physiological and Antioxidant Response to Different Water Deficit Regimes of Flag Leaves and Ears of Wheat Grown under Combined Elevated CO2 and High Temperature.

Triticum aestivum L. cv. Gazul is a spring wheat widely cultivated in Castilla y León (Spain). Potted plants were grown in a scenario emulating the climate change environmental conditions expected by the end of this century, i.e., with elevated CO2 and high temperature under two water deficit regimes: long (LWD) and terminal (TWD). Changes in biomass and morphology, the content of proline (Pro), ascorbate (AsA) and glutathione (GSH), and enzymatic antioxidant activities were analyzed in flag leaves and ears. Additionally, leaf gas exchange was measured. LWD caused a decrease in biomass and AsA content but an increase in Pro content and catalase and GSH reductase activities in flag leaves, whereas TWD produced no significant changes. Photosynthesis was enhanced under both water deficit regimes. Increase in superoxide dismutase activity and Pro content was only observed in ears under TWD. The lack of a more acute effect of LWD and TWD on both organs was attributed to the ROS relieving effect of elevated CO2. Gazul acted as a drought tolerant variety with anisohydric behavior. A multifactorial analysis showed better adaptation of ears to water deficit than flag leaves, underlining the importance of this finding for breeding programs to improve grain yield under future climate change.

Masking Effect of Cassia grandis Sensory Defect with Flavoured Stuffed Olives.

Carao (Cassia grandis) is an America native plant characterized by its high iron content. This particular property allows its use as a natural additive to fix the black colour in California-style black olives, while masking its unpleasant aroma by stuffing olives with flavoured hydrocolloid. The tasting panel evaluated olives filled with unflavoured hydrocolloid with a fruity aroma, classified them as an extra category. Olives with the Carao addition presented a positive aroma, but also showed negative sensory attributes such as cheese, fermented and metallic flavours/aromas. The aroma of lyophilized Carao was better than the fresh one. The 'Mojo picón' aroma masked defective olives, allowing their classification from the second to the first commercial category. The volatile compounds belonged to the following families: terpenes, hydrocarbons, and oxygenated compounds, while the minor ones were alcohols and acid derivatives. The main volatile compounds identified were dialyl disulphide and 3-methyl-butanoic acid; among the minor ones were 2,4-dimethyl-hexane and dimethyl-silanediol and nonanal. Addition of fresh Carao increased the unpleasant aroma provoked by 3-methyl-butanoic acid, 2-methyl-butanoic acid and (E)-2-Decenal. Finally, an electronic device was able to discriminate these aromas and the results obtained agreed with those of the tasting panel and the volatile compounds.

What fuels suboptimal care of peripheral intravenous catheter-related infections in hospitals? A qualitative study of decision-making among Spanish nurses.

BACKGROUND: Peripheral intravenous catheters (PIVC) are commonly used in hospital worldwide. However, PIVC are not exempt from complications. Catheter-related bloodstream infections (CRBSI) increase morbidity and mortality rates, and costs for the healthcare organization. PIVC care is shaped by the complex mix of professional and organizational culture, such as knowledge gaps, low perception of impact of PIVCs on patient safety, or lack of hospital guidelines. AIM: To explore determinants of decision-making about the prevention of PIVC-BSI among nurses in Spanish hospitals. METHODS: We conducted a descriptive qualitative study with semi-structured interviews in three public hospitals, the Balearic Islands Health Care Service in Spain. We considered hospital ward nurses working routinely with inpatients at any of the three hospitals for enrolment in the study. We approached relevant informants to identify suitable participants who recruited other participants through a 'snowball' technique. Fourteen inpatient nurses from the hospital took part in this study between September and November 2018. We employed several triangulation strategies to underpin the methodological rigour of our analysis and conducted the member checking, showing the information and codes applied in the recording of the interviews to identify the coherence and any discrepancies of the discourse by participants. We used the COREQ checklist for this study. FINDINGS: We identified four major themes in the analysis related to determinants of care: The fog of decision-making in PIVC; The taskification of PIVC care; PIVC care is accepted to be suboptimal, yet irrelevant; and chasms between perceived determinants of poor PIVC care and its solutions. CONCLUSION: The clinical management of PIVCs appear ambiguous, unclear, and fragmented, with no clear professional responsibility and no nurse leadership, causing a gap in preventing infections. Furthermore, the perception of low risk on PIVC care impact can cause a relevant lack of adherence to the best evidence and patient safety. Implementing facilitation strategies could improve the fidelity of the best available evidence regarding PIVC care and raise awareness among nurses of impact that excellence of care.

Application of Electronic Nose to Discriminate Species of Mold Strains in Synthetic Brines.

The chemical composition of the brine for Spanish-style table olives plays a crucial role during the fermentation process. Traditional laboratory analysis requires a high consumption of reagents, highly qualified personnel, sophisticated equipment, long analysis times, and large amounts of samples. Analysis carried out using an electronic nose (E-nose) offers an alternative, non-destructive technique and is useful in determining alterations in brines caused by microorganisms. In the present research, nine mold strains isolated from spoiled olives were inoculated in synthetic brines to determine the effect of microbial development on sensory quality, volatile profile, and the capacity of E-nose to discriminate altered brines from the healthy ones. The brines inoculated with the mold strains presented negative attributes related to aromas of mold, wood, leather, rancidity and, organic solvents among others. The highest intensity of defect was presented by the brines inoculated with the strains Galactomyces geotricum (G.G.2); three Penicillium expansum (P.E.3, P.E.4, and P.E.20); one Penicillium glabrum (P.G.19); three Aspergillus flavus (A.F.9, A.F.18, and A.F.21); and one Fusarium solani (F.S.11). A total of 19 volatile compounds were identified by gas chromatography. Sensory analysis allowed us to classify the synthetic brines based on the degree of alteration produced by the mold strains used. Also, the E-nose data were able to discriminate the inoculated brines regardless of the intensity of the defect. These results demonstrate the capacity of the E-nose to discriminate alterations in brines produced by molds, thereby making it a useful tool to be applied during the elaboration process to detect early alterations in table olive fermentation.

Factors associated with adverse pregnancy outcomes in patients with systemic lupus erythematosus.

BACKGROUND: Pregnancies in Systemic lupus erythematosus (SLE) are considered high risk and associated with maternal and obstetric complications. OBJECTIVES: To determine the most important predictors for each of the main adverse pregnancy outcomes in SLE patients. METHODS: Patients with SLE were retrospectively analysed from 1990 to 2020. Maternal and fetal complications in pregnant women with SLE were retrieved. We compared clinical and analytical characteristics of SLE patients with adverse pregnancy outcomes to controls with SLE diagnosis without adverse pregnancy outcomes. Qualitative data were analysed by Chi-square test and Fisher's exact test. Continuous variables were analysed by using Student's t test. Multiple logistic regression was performed to determine the predictive factors for adverse pregnancy outcomes with adjustment of confounding factors. RESULTS: 135 multiparous women were included (42% with adverse pregnancy outcomes). A total of 57 pregnancies (42%) were linked to adverse outcomes. The occurrence of abortion was correlated with anti-DNAds (ß = 0.71, p = 0.04), renal involvement (ß = 0.28, p 0.03), antiphospholipid antibodies (APA) (ß = 0.29, p 0.03), erythrocyte sedimentation rate (ESR) elevation (ß = 0.81, p = 0.02) and C-reactive protein (CPR) elevation (ß = 0.91, p = 0.01). Stillbirth was also correlated with renal involvement (ß = 0.26, p = 0.04), APA (ß = 0.22, p = 0.03) and ESR elevation (ß = 0.53, p = 0.02). Preeclampsia was correlated with direct Coombs positivity (ß = 0.42, p = 0.01), serositis (ß = 0.31, p = 0.02), ESR elevation (ß = 0.52, p = 0.03) and CPR elevation (ß = 0.32, p = 0.04). Neonatal Lupus was correlated with anti-RNP (ß = 0.16, p = 0.03) and anti-Ro/SSA (ß = 0.16, p 0.02). CONCLUSIONS: The most unfavourable pregnancy outcome in women with SLE was spontaneous abortion. Renal involvement, anti-DNAds positivity, antiphospholipid antibody positivity, anti-Ro/SSA, elevated ESR and a younger age at disease onset increased the risk of pregnancy complications.