Multi-block classification of chocolate and cocoa samples into sensory poles.

The present study aims at developing an analytical methodology which allows correlating sensory poles of chocolate to their chemical characteristics and, eventually, to those of the cocoa beans used for its preparation. Trained panelists investigated several samples of chocolate, and they divided them into four sensorial poles (characterized by 36 different descriptors) attributable to chocolate flavor. The same samples were analyzed by six different techniques: Proton Transfer Reaction-Time of Flight-Mass Spectrometry (PTR-ToF-MS), Solid Phase Micro Extraction-Gas Chromatography-Mass Spectroscopy (SPME-GC-MS), High-Performance Liquid Chromatography (HPLC) (for the quantification of eight organic acids), Ultra High Performance Liquid Chromatography coupled to triple-quadrupole Mass Spectrometry (UHPLC-QqQ-MS) for polyphenol quantification, 3D front face fluorescence Spectroscopy and Near Infrared Spectroscopy (NIRS). A multi-block classification approach (Sequential and Orthogonalized-Partial Least Squares - SO-PLS) has been used, in order to exploit the chemical information to predict the sensorial poles of samples. Among thirty-one test samples, only two were misclassified.

Nocturnal hypertension in primary care patients with high office blood pressure: A regional study of the MAPAGE project.

Nocturnal hypertension (NH) is an independent cardiovascular risk factor. We aimed to describe the frequency of NH among primary care hypertensive patients and to analyze NH determinants. This observational, cross-sectional, multicenter study enrolled the patients of 23 general practitioners in Burgundy region, France. We included the first patient of the day with office blood pressure ≥ 140/90 mm Hg, whatever the reason for consultation. All included patients had 24-hour ambulatory blood pressure monitoring (ABPM). Nocturnal hypertension was considered nighttime mean blood pressure ≥ 120/70 mm Hg, as per current guidelines. Medical, sociodemographic, and deprivation data were collected. Nocturnal hypertensive and non-hypertensive patients were compared. The determinants of NH were identified using logistic regression models. From July 2015 to November 2018, 447 patients were analyzed. Mean office blood pressure was 158.6/91.5 mm Hg, and 255 patients (57.0%) were taking at least one antihypertensive drug. Among the 409 (91.5%) valid ABPM, 316 (77.3%) showed NH. In multivariate analyses, male sex (odds ratio [OR] = 2.20, 95% confidence interval [CI] 1.29-3.75), first office diastolic blood pressure >100 mm Hg (OR = 5.71, 95% CI 1.53-21.40), and current smoking (OR = 5.91, 95% CI 2.11-16.56) were independent predictors of NH. Obesity was associated with a reduced risk of NH (OR = 0.43, 95% CI 0.25-0.75). No association was found between deprivation status or sociodemographic factors and NH. To conclude, NH was identified in more than three out of four patients with high office blood pressure. Male smokers with high diastolic blood pressure were most affected by NH. ABPM may improve hypertension management in these patients.

Alcoholic fermentation as a potential tool for coffee pulp detoxification and reuse: Analysis of phenolic composition and caffeine content by HPLC-DAD-MS/MS.

High-performance liquid chromatography with diode array (HPLC-DAD) and liquid chromatograph triple quadrupole mass spectrometry (HPLC-MS/MS) were used to characterize raw and fermented coffee pulps in terms of their phenolic composition and caffeine content. The qualitative analysis showed no significant differences between the raw and the fermented pulps. Free hydroxycinnamic acids (HAs) were mainly chlorogenic acids, with 5-caffeoylquinic acid as the major compound. Bound HAs released caffeic acids during alkaline hydrolysis, and no bound ferulic and p-coumaric acids were detected. The fermentation process allowed the detoxification of the pulp from caffeine by 50%, while significantly reducing the amounts of residue by 64%. Moreover, the fermented products could be further processed to provide high added-value molecules with potential industrial applications, providing a new source of income for the small coffee producers.

The Log book for the secondary prevention of coronary artery disease: A pilot study.

INTRODUCTION: In secondary prevention (SP) of coronary artery disease (CAD), in particular after an acute myocardial infarction (MI), a better knowledge and self-management by the patient may have various supports. The Log book (LB) for CAD patients in Côte d'Or, was created in 2010 by a multidisciplinary team of healthcare professionals of Côte d'Or, from a regional care network. This pilot study evaluated LB as novel support for SP after acute MI. METHODS: A prospective study on 183 patients hospitalised for an acute MI in the region of Côte d'Or from 1st May to 30th October 2010. Patients were randomized in 91 patients who received an LB at the time of their hospitalisation (LB+ group), and 92 patients who were not given an LB (LB- group). The follow up (FU) was performed at 4 months and 1 year. RESULTS: Baseline characteristics were similar in the 2 groups, except for smoking, which was more frequent in the LB-group than in the LB+ group. At FU, LB was usually well accepted by both patients and their general practitioners (GP). At 4 months FU, the patients LB+ were more prone to see their general practitioners than patients LB- (100% vs 85% in the LB- group, P=0.007). Moreover, in LB+ group, there was a trend towards a more frequent physical activity, including exercise bike (P=0.009) and an increase in HDL-cholesterol (HDL-c) (P=0.165). At 1 year FU, body mass index from LB+ was more reduced than in patients LB- (P=0.029). Finally, there was a trend towards lower morbi-mortality (hospitalisation for cardiovascular cause or death) in the LB+ group than in the LB- group (11 vs 22%, P=0.083). CONCLUSION: This pilot study showed the feasibility of LB as a support for SP and its interest in post MI management in a local care network setting. In addition, our study provides encouraging data on the potential benefits of this pioneer tool for SP.

General practice and the Internet revolution. Use of an Internet social network to communicate information on prevention in France.

The popularity of social networks and the huge number of exchanges have made them immensely important for the communication of information. This French study explored prevention in hereditary breast cancer using a social Internet network to communicate information. The principal objective was to inform French women aged from 20 to 50 years, using the social network Facebook, about the warning signs of breast cancer in cases of a predisposition to the disease due to a genetic mutation. The secondary objectives were to inform people about screening. An information page entitled "hereditary breast cancer: and if I was concerned?" was distributed in 3 different ways: from friend to friend, via groups of persons, and by targeted advertising. Four articles and 11 messages were distributed over 27 days. The total number of visits for this period amounted to 1019. A total of 81 percent of the Internauts were women and 55 percent of the visitors were aged between 25 and 44 years. Other information campaigns concerning public health issues could be conducted using this tool. A legal framework is necessary to preserve the quality of the medical information provided. This new means of communication, used for prevention purposes, will add to other frequently used methods of communication.

Near infra-red characterization of changes in flavan-3-ol derivatives in cocoa (Theobroma cacao L.) as a function of fermentation temperature.

Flavan-3-ols were successfully extracted from cocoa by the Fast-Prep device and analyzed by HPLC-DAD, and their identifications were confirmed by injection of authentic standards. (-)-Epicatechin was the most abundant component with an average of 9.4 mg/g dried cocoa powder. More than 700 cocoa samples were used to calibrate the NIRS. An efficient calibration model was developed to accurately determine any flavan-3-ol compound of ground dried cocoa beans (SEP = 2.33 mg/g in the case of total flavan-3-ols). This performance enabled NIRS to be used as an efficient and easy-to-use tool for estimating the level of targeted compounds. The analysis of the PLS loadings of the model and pure epicatechin spectra gave proof that NIRS was calibrated on an indirect strong correlation resulting in the changes in flavan-3-ols during fermentation and their interaction with some major components, such as proteins. Total flavan-3-ol concentration fell from an average of 33.3 mg/g for unfermented samples to an average of 6.2 mg/g at the end of fermentation. Changes in flavan-3-ol content were dependent upon the origin and highly correlated to the fermentation level expressed as the sum of temperatures (average R(2) = 0.74), a good marker of the fermentation process and of the heterogeneity of the batch.

Impact of diverting general practitioner's after-hour calls to emergency medical dispatch centers in patients with acute myocardial infarction.

OBJECTIVE: The aim of this study was to analyze the impact of diverting off-hour calls to Emergency Medical Dispatch Centers (EMDC) on time delays and revascularization procedures for patients with ST-segment elevation myocardial infarction (STEMI) in a French region. METHODS: A total of 3376 consecutive patients admitted for acute STEMI were included from the RICO survey (a French regional survey for acute myocardial infarction). Patients were retrospectively classified into two groups: before (2001-2004) and after EMDC (2005-2008) implementation and followed up for mortality as primary outcomes. In addition, we examined the impact of the diversion on the delay to definitive care. RESULTS: During the study, 1781 (53%) patients were evaluated before and 1595 (47%) after the EMDC implementation. Access to healthcare facilities was similar for the two groups. The rate of off-hour calls remained stable over time. The median delay from first medical intervention to hospital admission decreased from 75 to 60 min. The off-hour median interval from door to primary percutaneous coronary intervention dropped from 152 to 98 min. The multivariate analyses showed that EMDC implementing reduced preadmission delays even when adjusting for potential confounders. Moreover, EMDC implementing was associated with a fall in 30-day mortality by 60% in patients admitted during off hours and undergoing primary percutaneous coronary intervention (10 vs. 4%). CONCLUSION: In a real world setting, improving the quality of prehospital organization was effective not only on reducing delays but also on improving access to revascularization. Our results showed the beneficial impact of EMDC implementing on management of STEMI.