SEX-RELATED DIFFERENCES IN THE PHENOTYPE AND COURSE OF INFLAMMATORY BOWEL DISEASE: SEXEII STUDY OF ENEIDA.

BACKGROUND AND AIMS: The impact of patient sex on the presentation of inflammatory bowel disease (IBD) has been poorly evaluated. Our aims were to assess potential disparities in IBD phenotype and progression between sexes. METHODS: Observational multicentre study that included patients with Crohn's disease (CD) or ulcerative colitis (UC) from the Spanish ENEIDA registry. Data extraction was conducted in July 2021. RESULTS: 51,595 patients with IBD were included, 52% were males and 25,947 had CD. The median follow-up after diagnosis was 9 years in males and 10 in females. In CD, female sex was an independent risk factor for medium disease onset (17-40 years) (RRR 1.45, 95% CI 1.31-1.62), later disease onset (>40 years) (RRR 1.55, 95% CI: 1.38-1.73), exclusive colonic involvement (OR 1.24, 95%CI 1.14-1.34), inflammatory behaviour (OR 1.14, 95%CI 1.07-1.21) and extraintestinal manifestations (OR 1.48, 95%CI 1.38-1.59). However, female sex was a protective factor for upper gastrointestinal involvement (OR 0.84, 95%CI 0.79-0.90), penetrating behaviour (OR 0.76, 95%CI 0.70-0.82), perianal disease (OR 0.77, 95CI% 0.71-0.82) and complications (OR 0.73, 95%CI 0.66-0.80). In UC, female sex was an independent risk factor for extraintestinal manifestations (OR 1.48, 95%CI 1.26-1.61). However, female sex was an independent protective factor for disease onset from age 40 onward (RRR 0.76, IC 95%: 0.66-0.87), left sided colonic involvement (RRR 0.72, 95% CI 0.67-0.78), extensive colonic involvement (RRR 0.59, 95%CI 0.55-0.64) and abdominal surgery (OR 0.78, 95%CI 0.69-0.88). CONCLUSIONS: There is sexual dimorphism in IBD. The patient's sex should be taken into account in the clinical management of the disease.

Evaluation of highly adsorptive Guefoams (multifunctional guest-containing foams) as a potential sorbent for determination of volatile organic compounds (VOCs) by means of thermal desorption.

The present work delves into the feasibility of employing a novel structured sorbent referred to as GFAD (Guefoam Adsorption Device) for the determination of volatile organic compounds (VOCs) in liquid samples. The chosen method has been static headspace sorptive extraction-thermal desorption gas chromatography mass spectrometry (HSSE-TD-GC-MS). The GFAD comprises an aluminum cellular material with a distinct replication structure and a solid guest phase consisting of activated carbon particles dispersed within the cavities of the cellular aluminum. The extensive specific surface area, robustness, and exceptional thermal conductivity of this pioneering material offer distinct advantages over commercially available polydimethylsiloxane-based Twister® devices. Therefore, the trapping efficiency for volatile organic compounds is enhanced, and it is possible to perform the analysis of concentrated samples. According to computational simulations, it has been demonstrated that GFAD has a high heat conductivity. As a result, the desorption efficiency is improved, and minimal temperature gradients are generated throughout the GFAD during the heating process. Besides, the energy consumption is significantly lowered, thus aligning with environmentally conscientious and sustainable analytical practices.The experimental results give a proof of the suitability of the GFAD for determining gaseous compounds in liquid samples through HSSE-TD-GC-MS. For volatile species, the new material provides higher peak areas and lower limits of detection than a commercially available Twister® device. Furthermore, the GFAD is reusable, its adsorbing properties remaining unchanged during, at least, 100 consecutive analyses. In addition, unlike to the Twister®, no intense siloxane peaks are observed in the chromatograms obtained with the GFAD. The feasibility of qualitative and semi-quantitative analysis with the new accessory has been demonstrated with both standards and a cereal bioethanol real sample.

Application of Dispersive Liquid-Liquid Aerosol Phase Extraction to the Analysis of Total and Individual Phenolic Compounds in Fried Extra Virgin Olive Oils.

Seventeen extra virgin olive oil samples from Valencian Community (Spain) were submitted to a domestic-frying process (180 °C) during different degradation times (5, 10, 30, 60, 120 min). A dispersive liquid-liquid aerosol phase extraction by using a methanol/water (50:50) extracting solution was used to isolate the polyphenol fraction. Total phenolic content (TPC) was determined, whereas the determination of seven individual target polyphenolic compounds (hydroxytyrosol, tyrosol, oleuropein, vanillic acid, p-coumaric acid, ferulic acid, and vanillin) was carried out by using ultrahigh-performance liquid chromatography coupled to a tandem mass spectrometer. Statistically significant differences in the TPC values were found for Blanqueta and Manzanilla samples from different harvesting years. The domestic-frying process impacted the TPC and the individual phenolic compounds content. Thermal treatment for 2 h gave rise to a 94% decrease in the TPC. A first-order kinetic model was suitable to accurately describe the degradation of the individual phenolic compounds.

Sensory Attributes and Instrumental Chemical Parameters of Commercial Spanish Cured Ewes' Milk Cheeses: Insights into Cheese Quality Figures.

The external appearance of some of the Protected Designation of Origin (PDO) cured cheeses is similar to other cheese samples made in Spain: 1 kg and 2.5-3 kg formats, cylindrical, and with or without a pleita mark on the surface. In this work, commercial cured ewe's milk cheese samples with a similar external appearance were analyzed, including five PDO and five non-PDO samples. The parameters analyzed were color, texture, pH, humidity, water activity, and the volatile profile. Additionally, a descriptive and consumer-sensory analysis of the cheese samples was carried out. Statistical analysis of the results showed that luminosity, color coordinates a* and b*, percentage of deformation, humidity, water activity, and acid contents were significantly higher in non-PDO cheese samples. The breaking force, maximum force, and the content of esters were significantly higher in those cheese samples with PDO. In addition, PDO cheese samples showed higher scores for all attributes evaluated by consumers, except for color. These results suggest that PDO cheeses are placed on the market with a higher degree of ripening than non-PDO ones and that consequently they are more positively valued by consumers.

Caustic Ingestion: A Risk-Based Algorithm.

INTRODUCTION: Caustic ingestion management could be improved with a diagnostic approach based on risk factors. This study aimed to develop an algorithm derived from predictive factors of a poor clinical course, to evaluate its diagnostic accuracy and resource consumption, and to compare it with 2 other approaches, a radiological one based on computed tomography and a classical one based on symptoms and endoscopy. METHODS: All patients older than 15 years presenting with caustic ingestion in our tertiary care hospital between 1995 and 2021 were prospectively included. Adverse outcome was defined as intensive care unit admission, emergency surgery, or death. Ingestion characteristics, symptoms, and laboratory and endoscopic findings were analyzed to determine the most relevant risk factors. Diagnostic accuracy and the number of examinations required were estimated and compared with the other 2 algorithms applied to our series. RESULTS: The sample included 532 cases of caustic ingestion, 13.2% (95% confidence interval [CI]: 10.3-16.0) of which had adverse outcomes. Volume and type of caustic substance; presence of symptoms and pharyngolaryngeal involvement; and neutrophilia, acidosis, and endoscopic injury were combined to develop an algorithm that would provide the highest diagnostic odds ratio (167.2; 95% CI: 71.9-388.7). Following this approach, half of the patients (50.6%; 95% CI: 46.2-55.1) would not require any examination and, overall, the need for endoscopy (20.0%; 95% CI: 16.4-23.5) and computed tomography (16.3%; 95% CI: 13.0-19.5) would be lower than that for the other 2 algorithms. DISCUSSION: A risk-based algorithm could improve caustic ingestion management by maintaining high diagnostic accuracy while reducing diagnostic test requirements.

Subcutaneous Infliximab [CT-P13], a True Biologic 2.0. Real Clinical Practice Multicentre Study.

BACKGROUND: Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is characterized by chronic relapsing intestinal inflammation. There are few data on the efficacy and safety in clinical practice of infliximab (CT-P13) in subcutaneous formulation (SC) for the treatment of patients with IBD. METHODS: Multicenter, prospective study of patients with IBD in clinical remission, who had their treatment changed from intravenous (IV) infliximab to SC. Two groups of patients were evaluated according to whether they were on IV infliximab treatment at standard or intensified doses before the switch. RESULTS: A total of 30 patients were on standard dosing and another 30 in intensified therapy. Treatment persistence in both groups at 6 months was greater than 95%. In both groups after the change, neither the biomarkers of inflammation nor the activity indices underwent significant changes at 3 and 6 months compared to the baseline value. Similarly, in both groups, infliximab trough levels showed a significant increase 3 and 6 months after the change to SC. No serious adverse events were registered. CONCLUSIONS: The CT-P13 SC brings a new anti-TNF era. Achieving much higher drug levels that are constant over time opens new paths to explore the management of patients with IBD: less immunogenicity, better perianal disease control and higher achievement of mucosal healing.

Oxygen Scavenger and Antioxidant LDPE/EVOH/PET-Based Films Containing ß-Carotene Intended for Fried Peanuts (Arachis hypogaea L.) Packaging: Pilot Scale Processing and Validation Studies.

The aim of this study was to develop an oxygen scavenger and antioxidant active packaging material for fried peanuts. The packaging solution, which has been made at the laboratory previously, has been developed by cast film extrusion and is composed of low-density polyethylene-ethylene vinyl alcohol-polyethylene terephthalate (LDPE/EVOH/PET)-based films containing ß-carotene (CAR). In comparison with film without additive, developed film presented an orange colouring (higher L* and b* values and lower a* values) and an increase in oxygen induction time (OIt) from 4.5 to 14.1 min. The incorporation of ß-carotene to the formulation also brings about a significant effect on the thermal stability as maximum degradation temperatures increased around 1%. Regarding the oxygen absorption capacity of the films, values of 1.39 ± 0.10 mL O2 per g of film at laboratory scale and 1.7 ± 0.3 mL O2 per g of multilayer (ML)/LDPE_CAR were obtained, respectively, after 3 days, proving the suitability of the packaging solutions as oxygen absorbers. To validate the packaging solution, the oxidative stability of fried peanuts packed in fabricated multilayer ß-carotene bags was evaluated for 3 months at 40 °C. The hexanal content remained constant during this period. Meanwhile, peanuts packed in ML without ß-carotene increased their hexanal content to 294%. This fact indicated a lower extent of oxidation in fried peanuts compared to food samples packaged in control films, suggesting the potential of ML/LDPE_CAR films as sustainable and antioxidant food packaging systems to offer protection against lipid oxidation in foods. Sensory evaluation confirmed that ML/LDPE_CAR films provided the peanut samples with an extra aroma due to the volatile degradation products of ß-carotene (such as ß-cyclocitral or 6-methyl-5-hepten-2-ol).

Management of patients with Intestinal Bowel Disease and COVID-19: A review of current evidence and future perspectives / Manejo de pacientes con enfermedad inflamatoria intestinal y COVID-19: revisión de la evidencia actual y perspectivas futuras

The COVID-19 pandemic has been a challenge for countries and health professionals worldwide. Viral entry by ACE-2 receptor and an excessive activation of the immune system are key to understand both incidence and severity of disease. Inflammatory Bowel Disease (IBD) represents a special condition associated with an inordinate response of the immune system to external agents. IBD treatments have been associated to an increased risk of bacterial and viral infections. This has raised the question of possible higher incidence and severity of COVID-19 infection in IBD patients. Several papers have been published during this year of pandemic to answer that question. Moreover, COVID-19 vaccination offers great promise in controlling infection in patients with IBD. Based on current evidence, patients with IBD do not have a higher incidence of COVID-19 than the general population, and they do not have worse disease evolution. Advanced age and presence of a greater number of comorbidities have been associated with worse outcomes, similar to the general population. Corticosteroids are associated to an increased risk of COVID-19 infection, higher hospitalization rate and higher risk of severe COVID-19. 5-ASA/Sulfasalazine and Thiopurines have a possible increased risk of severe COVID-19, although studies are lacking. On the other hand, Anti-TNF may have a possible protective effect. It is recommended to maintain the treatment. Anti-IL-12/23, anti-integrins and tofacitinib have results comparable to anti-TNF. Based on the efficacy, expert recommendations, and the absence of other evidence, it is recommended that patients with IBD be vaccinated.(AU)

La pandemia por COVID-19ha supuesto un reto para los países y sus profesionales sanitarios. La entrada viral en el hospedador a través del receptor ACE-2 y una activación excesiva del sistema inmunológico son claves para comprender tanto la incidencia como la gravedad de la enfermedad. La enfermedad inflamatoria intestinal (EII) representa una condición especial asociada con una respuesta descontrolada del sistema inmunológico a agentes externos. Los tratamientos para la EII se han asociado con un mayor riesgo de infecciones bacterianas y virales, lo que ha planteado la cuestión de una posible mayor incidencia y gravedad de la infección por COVID-19 en pacientes con EII. A lo largo del año 2021 se han publicado varios artículos que tratan de responder esta cuestión. La vacunación contra la COVID-19 ofrece una gran promesa para controlar la infección en pacientes con EII. Según la evidencia actual, los pacientes con EII no tienen mayor incidencia de COVID-19 ni peor evolución de la enfermedad en comparación con la población general. La edad avanzada y la presencia de un mayor número de comorbilidades se han asociado con peores resultados. Los corticosteroides están asociados con un mayor riesgo de infección por COVID-19, una mayor tasa de hospitalizaciones y un mayor riesgo de enfermedad grave. La mesalazina/sulfasalazina y las tiopurinas presentan un posible aumento del riesgo de COVID-19 grave, aunque se requieren más estudios para demostrar esta asociación. Dentro de los fármacos biológicos, los anti-TNF pueden tener un posible efecto protector. Los anti-IL-12/23, anti-integrinas y tofacitinib presentan resultados comparables con anti-TNF. Se recomienda mantener el tratamiento con agentes biológicos. Con base en la eficacia, las recomendaciones de los expertos y la ausencia de otra evidencia, se recomienda la vacunación de pacientes con EII.(AU)

Management of patients with Intestinal Bowel Disease and COVID-19: A review of current evidence and future perspectives.

The COVID-19 pandemic has been a challenge for countries and health professionals worldwide. Viral entry by ACE-2 receptor and an excessive activation of the immune system are key to understand both incidence and severity of disease. Inflammatory Bowel Disease (IBD) represents a special condition associated with an inordinate response of the immune system to external agents. IBD treatments have been associated to an increased risk of bacterial and viral infections. This has raised the question of possible higher incidence and severity of COVID-19 infection in IBD patients. Several papers have been published during this year of pandemic to answer that question. Moreover, COVID-19 vaccination offers great promise in controlling infection in patients with IBD. Based on current evidence, patients with IBD do not have a higher incidence of COVID-19 than the general population, and they do not have worse disease evolution. Advanced age and presence of a greater number of comorbidities have been associated with worse outcomes, similar to the general population. Corticosteroids are associated to an increased risk of COVID-19 infection, higher hospitalization rate and higher risk of severe COVID-19. 5-ASA/Sulfasalazine and Thiopurines have a possible increased risk of severe COVID-19, although studies are lacking. On the other hand, Anti-TNF may have a possible protective effect. It is recommended to maintain the treatment. Anti-IL-12/23, anti-integrins and tofacitinib have results comparable to anti-TNF. Based on the efficacy, expert recommendations, and the absence of other evidence, it is recommended that patients with IBD be vaccinated.

Optimization of Volatile Compounds Extraction from Industrial Celery (Apium graveolens) By-Products by Using Response Surface Methodology and Study of Their Potential as Antioxidant Sources.

In this study, the potential of industrial celery by-products (the stalk and root) serving as sources of aromatics and antioxidants was investigated. A headspace solid phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) procedure was optimized to isolate volatile compounds from celery by-products. A Box-Behnken experimental design was proposed to optimize the procedure through a response surface methodology. The optimal extraction conditions were found to be 1.6 g of homogenized fresh by-product at 30 °C for 60 min. Under these conditions, 26 volatile compounds in stalk and root samples were identified, monoterpenes and sesquiterpenes being the main components. The content of limonene and γ-terpinene found in the stalk was significantly higher in comparison with root samples. Total phenolic content and antioxidant activity (ABTS and FRAP) results underlined the celery wastes studied as good sources of free radical scavengers. This work suggests the potential application of these by-products in the food industry and opens new pathways to valorize celery residues, contributing to the circular economy.

Potential of Industrial Pineapple (Ananas comosus (L.) Merrill) By-Products as Aromatic and Antioxidant Sources.

Pineapple is meanly commercially processed. However, it is a fruit that generates a high proportion of nonedible wastes, which are rich in antioxidant compounds and have a varied aromatic profile. These characteristics turn these by-products into potential agri-food waste that can be revalued and applied in different fields such as medical, pharmaceutical, or food applications. The aim of the present work was the characterization and extraction of the volatile compounds present in two pineapple by-products (peel and core) and the subsequent evaluation of their antioxidant capacity. For this purpose, the analysis of the aromatic profile of both by-products has been carried out using the headspace solid-phase microextraction technique coupled to gas chromatography with a mass spectrometry detector (HS-SPME-GC-MS). The optimization of the extraction conditions of the volatile compounds has been validated using a Box-Behnken experimental design. In addition, a quantitative analysis was carried out to determine the contents of two important volatiles in pineapple wastes, isopentyl, and ethyl acetate. Moreover, the estimation of the antioxidant capacity of the subproducts extracts was carried out using different methods All the antioxidant assays demonstrated that pineapple subproducts are rich in easily extractable antioxidants with possible applications in the food industry.

Volatile Profile of Nuts, Key Odorants and Analytical Methods for Quantification.

The presence of nuts in diets has notably increased due to their composition, and the presence of antioxidants and their unsaturated fatty acid profile has led to a considerable increase in their consumption. The volatile profile of nuts is important from different points of view. It affects consumer's selection, influences raw material selection for the production of composite foods, dictates variety selection in breeding programs, and, from a quality perspective, its changes can indicate food degradation or alteration. A review of the published bibliography concerning the determination of volatiles in nuts has been carried out. The information retrieved has been divided into four main sections. First, a discussion on the main volatiles present in nuts is performed; next, a revision of the methods used to determine the volatiles is presented; and, finally, two sections describing how harvesting conditions, healthy state and the thermal treatment of nuts modifies their volatile profile are added. Analysis of the published bibliography denoted the complexity of volatile determination and the different variables that can modify the compounds present in the volatile fraction of nuts.

Endoscopic submucosal dissection with an SB Knife® for the treatment of subcardial gastric leiomyoma.

Surgery has been considered the main treatment for submucosal tumors (SMTs). However, endoscopic resection is currently accepted for gastric SMTs smaller than 3 cm. Endoscopic submucosal dissection (ESD) is considered the technique of choice, and submucosal tunneling endoscopic resection has successful results with low complication rates according to the recent meta-analysis by Cao et al. The major limitation of these methods is the technical difficulty associated with certain anatomic locations.

Double-Function Oxygen Scavenger and Aromatic Food Packaging Films Based on LDPE/Polybutadiene and Peanut Aroma.

The aim of this study was to develop a double function active packaging material for nuts. The packaging solution, on the one hand, integrated polybutadiene (PB) as an oxygen scavenger and, on the other hand, it incorporated peanut aroma (PA) to improve customer's sensorial experience. Different formulations based on low density polyethylene (LDPE), commercial PA (5 wt %) and PB at two levels (5 wt % and 13 wt %) were obtained by cast film extrusion. The obtained films were compared in terms of their mechanical, structural, optical and thermal properties confirming a plasticizing effect of PA and PB resulting in an increase in the ductility of the polymer and in a slight decrease in the thermal properties, maintaining their transparency. Regarding the oxygen capacity of the films, values of 4.4 mL and 2.7 mL O2 g-1 film were obtained for PE/PA/PB13 and PE/PA/PB5, respectively, after 6 days proving the suitability of the UV irradiation treatment in improving the oxygen absorption capacity of PB without the need of a metal catalyst. The aroma retention capacity into the polymer matrix was also evaluated in the developed formulations. The incorporation of PB in 13 wt % into a LDPE matrix improved the PA retention. This behavior was attributed to the ability of PB in enhancing cross-linking of LDPE as the concentration of PB increases. The results suggested the potential of PE/PB/PB13 films as oxygen scavenger and aromatic food packaging system to offer protection against lipid oxidation in nuts.

Effect of Frying and Roasting Processes on the Oxidative Stability of Sunflower Seeds (Helianthus annuus) under Normal and Accelerated Storage Conditions.

The effect of different cooking processes such as frying and roasting on the oxidative stability of sunflower seeds was evaluated under accelerated oxidation and normal storage conditions. The fatty acid composition by GC-MS showed a higher amount of linoleic acid in fried samples due to the replacement of the seed moisture by the frying oil. On the other hand, roasted samples presented a higher oleic acid content. DSC and TGA results showed some decrease in the thermal stability of sunflower seed samples, whereas PV and AV showed the formation of primary and secondary products, with increasing oxidation time. Roasted sunflower seeds showed seven main volatile compounds characteristic of the roasting process by HS-SPME-GC-MS: 2-pentylfuran, 2,3-dimethyl-pyrazine, methyl-pyrazine, 2-octanone, 2-ethyl-6-methylpyrazine, trimethyl-pyrazine, and trans,cis-2,4-decadienal, whereas fried samples showed six volatile characteristic compounds of the frying process: butanal, 2-methyl-butanal, 3-methyl-butanal, heptanal, 1-hexanol, and trans,trans-2,4-decadienal. The generation of hydroperoxides, their degradation, and the formation of secondary oxidation products were also investigated by ATR-FTIR analysis. The proposed methodologies in this work could be suitable for monitoring the quality and shelf-life of commercial processed sunflower seeds with storage time.

New Trends in the Use of Volatile Compounds in Food Packaging.

In the last years, many of the research studies in the packaging industry have been focused on food active packaging in order to develop new materials capable of retaining the active agent in the polymeric matrix and controlling its release into food, which is not easy in many cases due to the high volatility of the chemical compounds, as well as their ease of diffusion within polymeric matrices. This review presents a complete revision of the studies that have been carried out on the incorporation of volatile compounds to food packaging applications. We provide an overview of the type of volatile compounds used in active food packaging and the most recent trends in the strategies used to incorporate them into different polymeric matrices. Moreover, a thorough discussion regarding the main factors affecting the retention capacity and controlled release of volatile compounds from active food packaging is presented.

Variability of Chemical Profile in Almonds (Prunus dulcis) of Different Cultivars and Origins.

Almonds show a great variability in their chemical composition. This variability is a result of the existence of a diverse range of almond cultivars, the self-incompatibility of most almond cultivars, and the heterogeneous harvesting conditions found around the different locations where almons are grown. In the last years, the discrimination among almond cultivars has been the focal point of some research studies to avoid fraud in protected geographical indications in almond products and also for selecting the best cultivars for a specific food application or the most interesting ones from a nutritional point of view. In this work, a revision of the recent research works related to the chemical characterization and classification of almond cultivars from different geographical origins has been carried out. The content of macronutrients, tocopherols, phytosterols, polyphenols, minerals, amino acids, and volatile compounds together with DNA fingerprint have been reported as possible cultivar and origin markers. The analysis of the results showed that no individual almond compound could be considered a universal biomarker to find differences among different almond cultivars. Hence, an adequate selection of variables or the employment of metabolomics and the application of multivariate statistical techniques is necessary when classification studies are carried out to obtain valuable results. Meanwhile, DNA fingerprinting is the perfect tool for compared cultivars based on their genetic origin.

The effect of sewage sludge containing microplastics on growth and fruit development of tomato plants.

Microplastics (MPs) are becoming an environmental growing concern, being the sewage sludge applied to agriculture fields one of the most important inputs to the environment. To date, there is no standardized protocol for their extraction and changes in vegetative growth and fruit maturation on cultivated plants induced by sludge containing MPs have not been studied yet. Sewage sludge from three different wastewater treatment plants located in Murcia, Spain, were studied. First, the microplastic concentration was estimated and, then, the effects of the sewage sludge in the development of tomato plants and fruit production was analyzed. The measured parameters in tomato plants were both, biomass and length, for shoot and root part, as well as, stem diameter and tomato production. The present work has developed and validated a protocol for the extraction and quantification of MPs comprising several shapes, materials and sizes from samples of sewage sludges, which offers a good compromise for the extraction of different types of microplastic. The protocol used for MPs extraction had a recovery efficiency of 80 ± 3% (mean ± SE) and used bicarbonate, to maximize MPs extraction. The mean abundance of MPs in the studied sewage sludge samples was 30,940 ± 8589 particles kg-1 dry weight. Soils with sludge containing MPs fostered the growth of tomato plants, while delaying and diminished fruit production. However, other factors or their interactions with MPs could have influenced the outcomes. Further studies are necessary to corroborate these findings and explain the mechanisms of possible effects of MPs on plants.

Caustic ingestion: development and validation of a prognostic score.

BACKGROUND: Caustic ingestion is a potentially severe condition and early identification of poor outcome is essential to improve management; however, prediction based on endoscopy alone can overestimate severity. This study aimed to develop and validate a prognostic score. METHODS: A prospective cohort study was designed to include all consecutive patients aged > 15 years who presented with caustic ingestion between 1995 and 2017. Adverse outcome was defined by intensive care unit admission, urgent surgery, or death. The predictive value of clinical, analytical, and endoscopic variables was assessed in the first cohort (derivation cohort) and a prognostic score based on the resulting risk factors was developed by logistic regression. Internal validation (bootstrapping) was performed and then external validation was checked in an independent sample of patients (validation cohort). RESULTS: 469 cases of caustic ingestion were included, 265 in the derivation cohort and 204 in the validation cohort. Ingestion of acidic substances (odds ratio [OR] 3.13, 95 % confidence interval [CI] 2.33 - 4.21), neutrophil count (OR 1.05, 95 %CI 1.04 - 1.06), metabolic acidosis (bicarbonate value, OR 0.82, 95 %CI 0.78 - 0.85), and endoscopic injury (OR 3.81, 95 %CI 3.35 - 4.34) were independent risk factors for poor outcome. The prognostic score based on these variables provided better accuracy than endoscopy alone (P = 0.04), with high sensitivity, specificity, positive and negative predictive values (93.3 %, 92.7 %, 72.7 %, 98.5 %, respectively), and area under the curve (0.976, 95 %CI 0.973 - 0.979; P < 0.001). CONCLUSIONS: This score allowed a reliable prognosis of caustic ingestion and was more accurate than endoscopy-based evaluation.

Biodegradable plastics can alter carbon and nitrogen cycles to a greater extent than conventional plastics in marine sediment.

The seabed constitutes a global sink for plastic debris, where they can remain for centuries. Biodegradable plastics offer the advantage of having less persistence in the environment than conventional ones. The seabed is responsible for key ecosystem functions related to the cycling of elements by decomposing the labile fraction of organic matter and fueling primary production, while storing the most recalcitrant part of this organic matter and limiting CO2 emissions. Although plastics are expected to affect these processes, knowledge on this matter is scarce. In controlled microcosms, we show that biodegradable plastics can stimulate the decomposition of marine-buried carbon and reduce the release of inorganic nitrogen. We found that conventional and biodegradable plastics promoted anaerobic sediment metabolic pathways. Biodegradable plastics produced a two-fold CO2 release to the water column, which suggests the decomposition of not only plastics, but also of buried organic carbon. The stimulation of sediment metabolism could be due to excessive carbon consumption by bacteria that derives from a rise in the carbon:nitrogen ratio. Accordingly, the NH4+ flux to the water column lowered. As NOx fluxes also lowered, biodegradable plastics might promote nitrification-denitrification coupling. If biodegradable plastics become a major component of marine pollution, then sediment biogeochemical cycles might be strongly influenced, which could affect the carbon sequestration of coastal ecosystems and compromise their mitigation capacity against climate change.