A Bayesian approach for mixed effects state-space models under skewness and heavy tails.

Human immunodeficiency virus (HIV) dynamics have been the focus of epidemiological and biostatistical research during the past decades to understand the progression of acquired immunodeficiency syndrome (AIDS) in the population. Although there are several approaches for modeling HIV dynamics, one of the most popular is based on Gaussian mixed-effects models because of its simplicity from the implementation and interpretation viewpoints. However, in some situations, Gaussian mixed-effects models cannot (a) capture serial correlation existing in longitudinal data, (b) deal with missing observations properly, and (c) accommodate skewness and heavy tails frequently presented in patients' profiles. For those cases, mixed-effects state-space models (MESSM) become a powerful tool for modeling correlated observations, including HIV dynamics, because of their flexibility in modeling the unobserved states and the observations in a simple way. Consequently, our proposal considers an MESSM where the observations' error distribution is a skew-t. This new approach is more flexible and can accommodate data sets exhibiting skewness and heavy tails. Under the Bayesian paradigm, an efficient Markov chain Monte Carlo algorithm is implemented. To evaluate the properties of the proposed models, we carried out some exciting simulation studies, including missing data in the generated data sets. Finally, we illustrate our approach with an application in the AIDS Clinical Trial Group Study 315 (ACTG-315) clinical trial data set.

Influence of microbial in-situ heteropolysaccharide production on textural properties of raw fermented sausages (salami).

The purpose of the study was to investigate the influence of a heteropolysacchride (HePS)-forming lactic acid bacteria (LAB) on the quality attributes of raw fermented sausages. Therefore, salamis with the HePS-producing strain Lactobacillus plantarum TMW 1.1478 or the non-EPS-producing strain Lactobacillus sakei TMW 1.2037 (control) were manufactured using two different inoculation concentrations: more precisely, 107 CFU/g (typical starter culture concentration) or 109 CFU/g. Growth behavior, aw and pH development were recorded until a weight loss of 31% was reached and in-situ-formed EPS detected using confocal laser scanning microscopy. Moreover, the influence of the HePS formed on texture (texture profile analysis; TPA) and sensory attributes (26 panelists, ranking test) was investigated. The final products containing L. plantarum TMW 1.1478 were found to be significantly softer (p < 0.05) than the respective control samples, an effect that was even more pronounced at the higher inoculation level of 109 CFU/g. The semi-quantitative data interpretation of the CLSM pictures revealed that the EPS were predominantly formed during the first 72 h of fermentation at 24 °C until the final pH of 4.95 ± 0.05 was reached (stationary phase). The sensory evaluation (consistency) was in accordance with the TPA results and taste was not negatively influenced by the HePS-forming strain. Results clearly indicate that EPS-producing LAB can have a negative influence on the quality of raw fermented sausages. However, these strains (in the present case L. plantarum TMW 1.1478) might be interesting for application in the field of spreadable raw sausage manufacturing.

Usage of in situ exopolysaccharide-forming lactic acid bacteria in food production: Meat products-A new field of application?

In the meat industry, hydrocolloids and phosphates are used to improve the quality attributes of meat products. However, latest research results revealed that the usage of exopolysaccharide (EPS)-forming lactic acid bacteria (LAB), which are able to produce EPS in situ during processing could be an interesting alternative. The current review aims to give a better understanding of bacterial EPS production in food matrices with a special focus on meat products. This includes an introduction to microbial EPS production (homopolysaccharides as well as heteropolysaccharides) and an overview of parameters affecting EPS formation and yield depending on LAB used. This is followed by a summary of methods to detect and characterize EPS to facilitate a rational selection of starter cultures and fermentation conditions based on desired structure-function relationships in different food matrices. The mechanism of action of in situ generated EPS is then highlighted with an emphasis on different meat products. In the process, this review also highlights food additives currently used in meat production that could in the future be replaced by in situ EPS-forming LAB.

Sulfadiazine Plus Pyrimethamine Therapy Reversed Multiple Behavioral and Neurocognitive Changes in Long-Term Chronic Toxoplasmosis by Reducing Brain Cyst Load and Inflammation-Related Alterations.

Toxoplasma gondii infects one-third of the world population. For decades, it has been considered a silent lifelong infection. However, chronically T. gondii-infected persons may present psychiatric and neurocognitive changes as anxiety, depression, and memory loss. In a model of long-term chronic infection, behavioral alterations parallel neuroinflammation and systemic high cytokine levels, and may reflect brain cyst load. Recent findings support that in chronic infection an active parasite-host interplay involves an immune-mediated control of tissue cysts. Here, we tested the idea that etiological treatment in chronic phase may add advantage to intrinsic immune-mediated cyst control and impact behavioral changes. Thus, we combined sulfadiazine-plus-pyrimethamine (S+P), the first-choice therapy for toxoplasmosis, to study the association of brain cyst load and biological processes related to the immune response (neuroinflammation, blood-brain barrier -BBB- disruption and serum cytokine levels), with behavioral and neurocognitive changes of long-term chronic infection. Female C57BL/6 mice (H-2b) were infected (5 cysts, ME-49 strain) and treated with S+P from 30 to 60 days postinfection (dpi), compared with vehicle (Veh)-treated and noninfected controls. At endpoints (pre-therapy, 30 dpi; S+P therapy, 60 dpi; after ceased therapy, 90 dpi), independent groups were subjected to behavioral tests, and brain tissues and sera were collected. Multiple behavioral and neurocognitive changes were detected in the early (30 dpi) and long-term (60 and 90 dpi) chronic infection. S+P therapy resolved locomotor alterations, anxiety, and depressive-like behavior, partially or transiently ameliorated hyperactivity and habituation memory loss. Analysis after therapy cessation showed that S+P therapy reduced the number of stimuli required for aversive memory consolidation. S+P therapy resulted in reduced brain cyst load, neuroinflammation and BBB disruption, and lowered systemic Th1-cytokine levels. Correlation analysis revealed association between IFNγ, TNF and MCP-1/CCL2 serum levels, brain cyst load and behavioral and neurocognitive alterations. Moreover, principal-component analysis (PCA-2D and 3D projections) highlighted distinction between clusters (noninfected; Veh-treated and S+P-treated infected). Thus, our data suggest that S+P therapy added gain to intrinsic brain cyst control and, direct or indirectly, ameliorated inflammation-related alterations, traits associated with behavioral and neurocognitive alterations.

Effect of olive powder and high hydrostatic pressure on the inactivation of Bacillus cereus spores in a reference medium.

The aim of this work was to study the effect of olive powder combined with high hydrostatic pressure (HHP) on the inactivation of Bacillus cereus spores, to use it as an additional control hurdle in beverages pasteurised by this technology. With this purpose, reference medium prepared at different concentrations of olive powder was inoculated with B. cereus spores and subjected to different pressure treatments. The outgrowth capacity of the treated spores was then determined at 20°C and 32°C. The addition of olive powder was found to slightly reduce the effectiveness of HHP, although in post-treatment storage there was an increased bacteriostatic effect in the samples with 2.5% of olive powder at both temperatures in the samples pressurised at 400 and 500 MPa, and only at 20°C in the samples pressurised at 200 MPa. The addition of olive powder therefore had an additive effect with storage temperature and HHP processing and could act as an additional control hurdle during the shelf-life of products pasteurised by HHP technologies or in the case of cold-chain breakage.

Influence of fermentation temperature on in situ heteropolysaccharide formation (Lactobacillus plantarum TMW 1.1478) and texture properties of raw sausages.

This study puts a focus on the influence of microbial in situ heteropolysaccharide (HePS) formation on the quality of raw fermented sausages (salami). Since exopolysaccharide-production is often triggered by sub-optimal growth conditions, the influence of different fermentation temperatures was also investigated. For this reason, the sausage batter was inoculated with (Lactobacillus plantarum TMW 1.1478) or without (L. sakei TMW 1.2037; control) a HePS-producing starter culture (inoculation concentration ~108 CFU/g), and the sausages fermented at either 10, 16, or 24°C (7 days), followed by a drying period at 14°C until the final weight loss of 31% was reached. Microbial growth, pH, and weight loss development were monitored and the products further characterized using texture profile analysis and a sensory test. HePS in the salami matrix were determined using confocal laser scanning microscopy and a semi-quantitative data interpretation approach. Sausages containing L. plantarum were found to be significantly (p < .05) softer compared with control samples, which was also confirmed in the sensory analysis. The different fermentation temperatures had an influence on the drying speed. Here, sausages produced with L. plantarum needed more time to reach the final weight loss of 31% as compared to control samples, which could be attributed to the presence of exopolysaccharides in the matrix (p < .05). Using HePS-forming starter cultures in raw fermented sausage manufacturing can lead to products with a softer texture (undesired in Europe) depending on the strain and processing conditions used, highlighting the importance of a suitable starter culture selection in food processing.

Factors associated with delirium after cardiac surgery: A prospective cohort study.

Background: Delirium is a frequent complication after cardiac surgery and is associated with a higher incidence of morbidity and mortality and a prolonged hospital stay. However, knowledge of the variables involved in its occurrence is still limited; therefore, in this study, we evaluated the perioperative risk factors independently associated with this complication. Methods: This study was conducted in a referral tertiary care university hospital with a cardiovascular focus. A total of 311 consecutive adult patients undergoing any type of cardiac surgery were evaluated. The subjects were examined at regular intervals in the postoperative period using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) tool. Results: The incidence of postoperative delirium (PD) was 10%. Among the 18 pre-, intra- and postoperative variables evaluated, the logistic regression analysis showed that low education level, history of diabetes or stroke, type of surgery, prolonged extracorporeal circulation, or red blood cell transfusion in the intra- or postoperative period were independently associated with delirium after cardiac surgery. An increased body mass index was identified as a protective factor. Conclusions: The aforementioned risk factors are significantly and independently associated with the presentation of PD. Because some of these factors can be treated or avoided, the results of this study are highly relevant to reduce the risk of this complication and improve the care of patients undergoing cardiac surgery.