Early postoperative feeding following surgery for upper gastrointestinal cancer: A systematic review.

Nutrition post major upper gastrointestinal (UGI) cancer surgery is a significant consideration known to affect postoperative recovery and the ability to tolerate adjuvant treatment. This systematic review assessed the effect of early oral feeding (EOF), compared to traditional timing of oral feeding, following major surgery for UGI cancer on postoperative complications, postoperative length of hospital stay (LOS), nutritional status and quality of life (QOL). The literature was searched up to March 9th 2020 using CINHAL, PubMed, MEDLINE, Embase, Scopus and Web of Science databases. Quality assessment was completed using the Academy of Nutrition and Dietetics quality criteria checklist. Fifteen articles were included, consisting of seven randomised controlled trials, six cohort studies and two non-randomised trials, with a total of 2517 participants. The type and timing of EOF varied considerably across studies with limited reporting of energy and protein intakes from oral or enteral feeding. Fourteen studies assessed postoperative complications of which 13 reported no difference between EOF and standard care. Fourteen studies assessed postoperative LOS and of these, 13 reported a reduced length of stay in the EOF group. Four of 15 studies assessing nutritional status found no difference between groups. Three of 15 studies assessed QOL with inconsistent findings. This review found EOF reduced postoperative LOS and did not increase postoperative complications. However, the optimal timing for the introduction of EOF could not be established. Furthermore, the type of EOF varied considerably making comparison across studies challenging and demonstrates a need for internationally standardised definitions.

Synchronized reinjection and coalescence of droplets in microfluidics.

Coalescence of two kinds of pre-processed droplets is necessary to perform chemical and biological assays in droplet-based microfluidics. However, a robust technique to accomplish this does not exist. Here we present a microfluidic device to synchronize the reinjection of two different kinds of droplets and coalesce them, using hydrostatic pressure in conjunction with a conventional syringe pump. We use a device consisting of two opposing T-junctions for reinjecting two kinds of droplets and control the flows of the droplets by applying gravity-driven hydrostatic pressure. The hydrostatic-pressure operation facilitates balancing the droplet reinjection rates and allows us to synchronize the reinjection. Furthermore, we present a simple but robust module to coalesce two droplets that sequentially come into the module, regardless of their arrival times. These re-injection and coalescence techniques might be used in lab-on-chip applications requiring droplets with controlled numbers of solid materials, which can be made by coalescing two pre-processed droplets that are formed and sorted in devices.

Tetrahedral colloidal clusters from random parking of bidisperse spheres.

Using experiments and simulations, we investigate the clusters that form when colloidal spheres stick irreversibly to--or "park" on--smaller spheres. We use either oppositely charged particles or particles labeled with complementary DNA sequences, and we vary the ratio α of large to small sphere radii. Once bound, the large spheres cannot rearrange, and thus the clusters do not form dense or symmetric packings. Nevertheless, this stochastic aggregation process yields a remarkably narrow distribution of clusters with nearly 90% tetrahedra at α = 2.45. The high yield of tetrahedra, which reaches 100% in simulations at α = 2.41, arises not simply because of packing constraints, but also because of the existence of a long-time lower bound that we call the "minimum parking" number. We derive this lower bound from solutions to the classic mathematical problem of spherical covering, and we show that there is a critical size ratio α(c) = (1 + sqrt[2]) ≈ 2.41, close to the observed point of maximum yield, where the lower bound equals the upper bound set by packing constraints. The emergence of a critical value in a random aggregation process offers a robust method to assemble uniform clusters for a variety of applications, including metamaterials.

Validation of lactic acid bacteria, lactic acid, and acidified sodium chlorite as decontaminating interventions to control Escherichia coli O157:H7 and Salmonella Typhimurium DT 104 in mechanically tenderized and brine-enhanced (nonintact) beef at the purveyor.

After three different outbreaks were linked to the consumption of nonintact meat products contaminated with Escherichia coli O157:H7, the U.S. Food Safety and Inspection Service published notice requiring establishments producing mechanically tenderized and moisture-enhanced beef products to reassess their respective hazard analysis and critical control point systems, due to potential risk to the consumers. The objective of this study was to validate the use of lactic acid bacteria (LAB), acidified sodium chlorite (ASC), and lactic acid (LA) sprays when applied under a simulated purveyor setting as effective interventions to control and reduce E. coli O157:H7 and Salmonella Typhimurium DT 104 in inoculated U.S. Department of Agriculture (USDA) Choice strip loins (longissimus lumborum muscles) pieces intended for either mechanical blade tenderization or injection enhancement with a brine solution after an aging period of 14 or 21 days at 4.4°C under vacuum. After the mechanical process, translocation of E. coli O157:H7 and Salmonella Typhimurium DT 104 from the surface into the internal muscles occurred at levels between 1.00 and 5.72 log CFU/g, compared with controls. LAB and LA reduced internal E. coli O157:H7 loads up to 3.0 log, while ASC reduced the pathogen 1.4 to 2.3 log more than the control (P < 0.05), respectively. Salmonella Typhimurium DT 104 was also reduced internally 1.3 to 2.8, 1.0 to 2.3, and 1.4 to 1.8 log after application of LAB, LA, and ASC, respectively. The application of antimicrobials by purveyors prior to mechanical tenderization or enhancement of steaks should increase the safety of these types of products.

Validation of intervention strategies to control Escherichia coli O157:H7 and Salmonella typhimurium DT 104 in mechanically tenderized and brine-enhanced beef.

After three different outbreaks were linked to the consumption of nonintact meat products contaminated with Escherichia coli O157:H7, the U.S. Department of Agriculture, Food Safety and Inspection Service published notice requiring establishments producing mechanically tenderized and moisture-enhanced beef products to reassess their respective hazard analysis and critical control point system, due to potential risk to the consumers. The purpose of this study was to determine the effectiveness of different intervention strategies (lactic acid, lactic acid bacteria, and acidified sodium chlorite) to control E. coli O157:H7 and Salmonella enterica serotype Typhimurium definitive phage type 104 in mechanically tenderized and brine-enhanced beef strip loins when applied to the steaks prior to packaging and shipment for processing. After the mechanical process, translocation of E. coli O157:H7 and Salmonella Typhimurium DT 104 from the surface into the internal muscles occurred at levels between 2.0 and 4.0 log CFU/g (from an initial inoculation level of 5.0 log) after mechanical tenderization, and at levels of 1.0 to 3.0 log CFU/g after injection, with all the interventions consistently presenting lower microbial counts (P < 0.05) than did the controls. Lactic acid bacteria reduced internal E. coli O157:H7 loads 1.2 to > 2.2 log cycles, while the acidified sodium chlorite and lactic acid reduced them between 0.8 and 3.0 log, respectively. Salmonella Typhimurium DT 104 was also reduced internally after application of all interventions between 0.9 and 2.2 log. The application of antimicrobials to the steaks prior to packaging and shipment on day 0 was effective in reducing internalization of both pathogens in nonintact beef products stored for both 14 and 21 days.

Continuous-flow lithography for high-throughput microparticle synthesis.

Precisely shaped polymeric particles and structures are widely used for applications in photonic materials, MEMS, biomaterials and self-assembly. Current approaches for particle synthesis are either batch processes or flow-through microfluidic schemes that are based on two-phase systems, limiting the throughput, shape and functionality of the particles. We report a one-phase method that combines the advantages of microscope projection photolithography and microfluidics to continuously form morphologically complex or multifunctional particles down to the colloidal length scale. Exploiting the inhibition of free-radical polymerization near PDMS surfaces, we are able to repeatedly pattern and flow rows of particles in less than 0.1 s, affording a throughput of near 100 particles per second using the simplest of device designs. Polymerization was also carried out across laminar, co-flowing streams to generate Janus particles containing different chemistries, whose relative proportions could be easily tuned. This new high-throughput technique offers unprecedented control over particle size, shape and anisotropy.