An overview of the factors influencing apple cider sensory and microbial quality from raw materials to emerging processing technologies

Given apple, an easily adapted culture, and a large number of apple varieties, the production of apple cider is widespread globally. Through the fermentation process, a series of chemical changes take place depending on the apple juice composition, type of microorganism involved and technology applied. Following both fermentations, alcoholic and malo-lactic, and during maturation, the sensory profile of cider changes. This review summarises the current knowledge about the influence of apple variety and microorganisms involved in cider fermentation on the sensory and volatile profiles of cider. Implications of both Saccharomyces, non-Saccharomyces yeast and lactic acid bacteria, respectively, are discussed. Also are presented the emerging technologies applied to cider processing (pulsed electric field, microwave extraction, enzymatic, ultraviolet and ultrasound treatments, high-pressure and pulsed light processing) and the latest trends for a balanced production in terms of sustainability, authenticity and consumer preferences

Ecological changes in historically polluted soils: Metal(loid) bioaccumulation in microarthropods and their impact on community structure

International audienceSoil pollution by persistent metal(loid)s present environmental and sanitary risks. While the effects of metal(loid)s on vegetation and macrofauna have been widely studied, their impact on microarthropods (millimetre scale) and their bioaccumulation capacity have been less investigated. However, microarthropods provide important ecosystem services, contributing in particular to soil organic matter dynamics. This study focussed on the impact of metal(loid) pollution on the structure and distribution of microarthropod communities and their potential to bioaccumulate lead (Pb). Soil samples were collected from a contaminated historical site with a strong horizontal and vertical gradient of Pb concentrations. Microarthropods were extracted using the Berlese method. The field experiments showed that microarthropods were present even in extremely polluted soils (30,000 mg Pb kg− 1). However, while microarthropod abundance increased with increasing soil C/N content (R2 = 0.79), richness decreased with increasing pollution. A shift in the community structure from an oribatid-to a springtail-dominated community was observed in less polluted soils (R2 = 0.68). In addition, Pb bioamplification occurred in microarthropods, with higher Pb concentrations in predators than in detritivorous microarthropods. Finally, the importance of feeding and reproductive ecological traits as potentially relevant descriptors of springtail community structures was highlighted. This study demonstrates the interest of microarthropod communities with different trophic levels and ecological features for evaluating the global environmental impact of metal(loid) pollution on soil biological quality

Cost-Effectiveness of Adolescent Pertussis Vaccination for The Netherlands: Using an Individual-Based Dynamic Model

BACKGROUND: Despite widespread immunization programs, a clear increase in pertussis incidence is apparent in many developed countries during the last decades. Consequently, additional immunization strategies are considered to reduce the burden of disease. The aim of this study is to design an individual-based stochastic dynamic framework to model pertussis transmission in the population in order to predict the epidemiologic and economic consequences of the implementation of universal booster vaccination programs. Using this framework, we estimate the cost-effectiveness of universal adolescent pertussis booster vaccination at the age of 12 years in the Netherlands. METHODS/PRINCIPAL FINDINGS: We designed a discrete event simulation (DES) model to predict the epidemiological and economic consequences of implementing universal adolescent booster vaccination. We used national age-specific notification data over the period 1996-2000--corrected for underreporting--to calibrate the model assuming a steady state situation. Subsequently, booster vaccination was introduced. Input parameters of the model were derived from literature, national data sources (e.g. costing data, incidence and hospitalization data) and expert opinions. As there is no consensus on the duration of immunity acquired by natural infection, we considered two scenarios for this duration of protection (i.e. 8 and 15 years). In both scenarios, total pertussis incidence decreased as a result of adolescent vaccination. From a societal perspective, the cost-effectiveness was estimated at €4418/QALY (range: 3205-6364 € per QALY) and €6371/QALY (range: 4139-9549 € per QALY) for the 8- and 15-year protection scenarios, respectively. Sensitivity analyses revealed that the outcomes are most sensitive to the quality of life weights used for pertussis disease. CONCLUSIONS/SIGNIFICANCE: To our knowledge we designed the first individual-based dynamic framework to model pertussis transmission in the population. This study indicates that adolescent pertussis vaccination is likely to be a cost-effective intervention for The Netherlands. The model is suited to investigate further pertussis booster vaccination strategies

Evolution of a Project to Improve Inpatient-to-Outpatient Dermatology Care Transitions: Mixed Methods Evaluation

BackgroundIn-hospital dermatological care has shifted from dedicated dermatology wards to consultation services, and some consulted patients may require postdischarge follow-up in outpatient dermatology. Safe and timely care transitions from inpatient-to-outpatient specialty care are critical for patient health, but communication around these transitions can be disjointed, and workflows can be complex. ObjectiveIn this 3-phase quality improvement effort, we developed and evaluated an intervention that leveraged an electronic health record (EHR) feature, known as SmartPhrase, to enable a new workflow to improve transitions from inpatient care to outpatient dermatology. MethodsPhase 1 (February-March 2021) included interviews with patients and process mapping with key stakeholders to identify gaps and inform an intervention: a SmartPhrase table and associated workflow to promote collection of patient information needed for scheduling follow-up and closed-loop communication between dermatology and scheduling teams. In phase 2 (April-May 2021), semistructured interviews—with dermatologists (n=5), dermatology residents (n=5), and schedulers (n=6)—identified pain points and refinements. In phase 3, the intervention was evaluated by triangulating data from these interviews with measured changes in scheduling efficiency, visit completion, and messaging volume preimplementation (January-February 2021) and postimplementation (April-May 2021). ResultsPreintervention pain points included unclear workflow for care transitions, limited patient input in follow-up planning, multiple messaging channels (eg, EHR based, email, and phone messages), and time-inefficient patient tracking. The intervention addressed most pain points; interviewees reported the intervention was easy to adopt and improved scheduling efficiency, workload, and patient involvement. More visits were completed within the desired timeframe of 14 days after discharge during the postimplementation period (21/47, 45%) than the preimplementation period (28/41, 68%; P=.03). The messaging workload also decreased from 88 scheduling-related messages sent for 25 patients before implementation to 30 messages for 8 patients after implementation. ConclusionsInpatient-to-outpatient specialty care transitions are complex and involve multiple stakeholders, thus requiring multifaceted solutions. With deliberate evaluation, broad stakeholder input, and iteration, we designed and implemented a successful solution using a standard EHR feature, SmartPhrase, integrated into a standardized workflow to improve the timeliness of posthospital specialty care and reduce workload