Future Proteins: Sustainable Diets for Tenebrio molitor Rearing Composed of Food By-Products.

Since the human population is continuously growing, sufficient food with low environmental impact is required. Especially, the challenge of providing proteins will deepen and insects can contribute to a more sustainable and efficient source of protein for human consumption. Tenebrio molitor larvae are highly nutritious and rearing mealworms is more environmentally friendly compared to the production of traditional livestock meat. To use T. molitor as a more sustainable alternative to conventional proteins, it is essential to apply diets from a local and sustainable source. Therefore, the objective of this study was to find local by-products or leftovers which can be used in mass production of larvae as a main substrate. Feeding trials investigating twenty-nine different substrates were conducted to evaluate larval growth performance and adult reproduction by determining development times, survival rates, biomass, and fecundity. Several suitable by-products were identified that can be used in high quantities as single component diet for T. molitor rearing, revealing a high survival rate, short development time, high mean total biomass, and successful breeding. The most successful substrate-malt residual pellets-was found to be an alternative to the most used substrate, wheat bran. Furthermore, corn germ meal, sweet chestnuts, bread remains, soybeans, sweet potatoes, and wheat germs have been discovered to be suitable diets for T. molitor. Moreover, the findings of this study contribute towards using several substrates as supplements.

Tenebrio molitor (Linnaeus, 1758): Microbiological Screening of Feed for a Safe Food Choice.

As a result of the increasing focus on alternative protein sources which are ideally still sustainable, the yellow mealworm, Tenebrio molitor, has come into focus. To verify its suitability as a food source in relation to human health, an analysis of the microbiome of larvae of T. molitor is pertinent. Subsequently, the focus of this study was, on the one hand, to analyze the influence of the substrate on the microbial load of the larvae microbiome, and, on the other hand, to determine which processing methods ensure the risk-free consumption of mealworms. For this purpose, mealworms were grown on 10 different substrates derived from by-products of food production (malt residual pellets, corn germ meal, chestnut breakage and meal, wheat bran, bread remains, draff, nettle, hemp seed oil cake, oyster mushrooms with coffee grounds, pumpkin seed oil cake) and microbial loads were analyzed using different selective media. Further starvation/defecation and heating (850 W for 10 min) methods were used to investigate how the reduction of microorganisms is enabled by these methods. The results showed that there was no significant relationship between the microbial load of the substrate and the mealworm. Starvation and defecation led to a lower stock of microorganisms. Heating led to a significant microbial reduction in non-defecated mealworms. The group of defecated and heated mealworms showed no detectable microbial load. In conclusion, firstly, the choice of substrate showed no effect on the microbial load of larvae of Tenebrio molitor and secondly, heating and starvation allow risk-free consumption. This study makes an important contribution for evaluating the safety of mealworms as a sustainable protein source in human nutrition.

Use Them for What They Are Good at: Mealworms in Circular Food Systems.

Future food systems must provide more food produced on less land with fewer greenhouse gas emissions if the goal is to keep planetary boundaries within safe zones. The valorisation of agricultural and industrial by-products by insects is an increasingly investigated strategy, because it can help to address resource scarcities and related environmental issues. Thus, insects for food and feed have gained increasing attention as a sustainable protein production strategy in circular food systems lately. In this article, we provide an overview on by-products, which have already been fed to T. molitor (mealworms), a common edible insect species. In addition, we investigate other by-products in Austria, which can be suitable substrates for T. molitor farming. We also provide an overview and discuss different perspectives on T. molitor and link it with the circular economy concept. We identify several future research fields, such as more comprehensive feeding trials with other by-products, feeding trials with mealworms over several generations, and the development of a standardized framework for insect rearing trials. In addition, we argue that due to their ability to convert organic by-products from agricultural and industrial processes into biomass in an efficient way, T. molitor can contribute towards resource-efficient and circular food and feed production. However, several hurdles, such as legal frameworks, need to be adapted, and further research is needed to fully reap the benefits of mealworm farming.

Listening to parents: The role of symptom perception in pediatric palliative home care.

OBJECTIVE: This study analyzes symptom perception by parents and healthcare professionals and the quality of symptom management in a pediatric palliative home care setting and identifies which factors contribute to a high quality of palliative and end-of-life care for children. METHODS: In this retrospective, cross-sectional study, parents were surveyed at the earliest three months after their child's death. All children were cared for by a specialized home pediatric palliative care team that provides a 24/7 medical on-call service. Questionnaires assessed symptom prevalence and intensity during the child's last month of life as perceived by parents, symptom perception, and treatment by medical staff. The responses were correlated with essential palliative care outcome measures (e.g., satisfaction with the care provided, quality-of-life of affected children and parents, and peacefulness of the dying phase). RESULTS: Thirty-eight parent dyads participated (return rate 84%; 35% oncological disorders). According to parental report, dyspnea (61%) and pain (58%) were the dominant symptoms with an overall high symptom load (83%). Pain, agitation, and seizures could be treated more successfully than other symptoms. Successful symptom perception was achieved in most cases and predicted the quality of symptom treatment (R 2, 0.612). Concordant assessment of symptom severity between parents and healthcare professionals (HCPs) improved the satisfaction with the care provided (p = 0.037) as well as the parental quality-of-life (p = 0.041). Even in cases with unsuccessful symptom control, parents were very satisfied with the SHPPC team's care (median 10; numeric rating scale 0-10) and rated the child's death as highly peaceful (median 9). Significance of the results: The quality and the concordance of symptom perception between parents and HCPs essentially influence parental quality-of-life as well as parental satisfaction and constitute a predictive factor for the quality of symptom treatment and palliative care.

Effectiveness of a pediatric palliative home care team as experienced by parents and health care professionals.

OBJECTIVES: Little data are available on palliative home care for children. The objective of this study was to evaluate the effectiveness of a specialized pediatric palliative home care team (PPHCT) as experienced by parents and health care professionals (HCPs). METHODS: Parents and HCPs involved in the care of terminally ill children who died and whom the PPHCT was in charge of were surveyed with questionnaires focusing on satisfaction with the PPHCT, satisfaction with the course of the dying phase, and the development of anxiety, depression, and prolonged grief disorder. RESULTS: Forty-three parent dyads participated (return rate, 88%). Satisfaction with the PPHCT scored a median of 10 (numeric rating scale, 0-10). The child's death was predominantly experienced as very peaceful (median, 9); 71% died at home. According to parents, involvement of the PPHCT led to highly significant (p<0.001) improvements in the children's symptoms and quality of life, as well as in aspects of communication and administrative barrier reduction. Anxiety was detected in 25% of parents, depression in 19%, and prolonged grief disorder in 13%. HCPs (return rate, 83%) evaluated all investigated care domains (particularly cooperation/communication/family support) as being significantly improved (p<0.001). Thirty-five percent of HCPs felt uncertain concerning pediatric palliative care; 79% would welcome specific training opportunities. CONCLUSIONS: Involvement of a PPHCT is experienced as a substantial improvement of care by parents and HCPs. Coordination of palliative care during the last phase of life appears to be an important quality factor for the home care of dying children and their families.

Acquired heart block: a possible complication of patent ductus arteriosus in a preterm infant.

A large patent ductus arteriosus (PDA) is a frequently encountered clinical problem in extremely low birth weight (ELBW) infants. It leads to an increased pulmonary blood flow and in a decreased or reversed diastolic flow in the systemic circulation, resulting in complications. Here we report a possible complication of PDA not previously published. On day 8 of life, a male ELBW infant (birth weight 650 g) born at a gestational age of 23 weeks and 3 days developed an atrioventricular block (AV block). The heart rate dropped from 168/min to 90/min, and the ECG showed a Wenckebach second-degree AV block and intraventricular conduction disturbances. Echocardiography demonstrated a PDA with a large left-to-right shunt and large left atrium and left ventricle with high contractility. Within several minutes after surgical closure of the PDA, the heart rate increased, and after 30 min the AV block had improved to a 1:1 conduction ratio. Echocardiography after 2 h revealed a significant decrease of the left ventricular and atrial dimensions. Within 12 h, the AV block completely reversed together with the intraventricular conduction disturbances. We suggest that PDA with a large left-to-right shunt and left ventricular volume overload may lead to an AV block in an ELBW infant. Surgical closure of the PDA may be indicated.

Endochondral gigantism: a newly recognized skeletal dysplasia with pre- and postnatal overgrowth and endocrine abnormalities.

We report on a 3-year-old male, born at 34 weeks of gestation, with marked pre- and postnatal overgrowth, birth weight of 6,600 g, length of 61 cm, and head circumference of 38.5 cm. A striking phenotype was recorded at birth, which became more evident during the follow-up period. He had macrobrachycephaly, facial abnormalities, small thoracic cage, long trunk, deformed spine, rhizomelia, large hands and feets, absent subcutaneous fat, small umbilical hernia, inguinal hernias, and large joints with mild contractures. Hypoglycemic episodes and obstructive apnea complicated the neonatal period. During follow-up, overgrowth continued with a height of 146 cm (+11.65 SDS) and a weight of 39 kg (BMI 18.3 kg/m(2)) at 3.5 years. Endocrinological work-up disclosed extremely low levels of growth hormone, insulin-like growth factors, and insulin. What makes our patient unique is the association of marked prenatal overgrowth; unusual phenotype; skeletal dysplasia caused by accelerated endochondral ossification resulting in cartilage hyperplasia of the skull base and spine, and postnatal gigantism; and complete absence of subcutaneous fat. Other well-known overgrowth syndromes were excluded. We hypothesize that autocrine/paracrine growth factors could be the cause of excessive endochondral ossification. Alternately, activating mutations in transcription factors involved in both growth and endocrine/metabolic homeostasis could be responsible for this unusual phenotype.