Taro leaves extract and probiotic lactic acid bacteria: A synergistic approach to improve antioxidant capacity and bioaccessibility in fermented milk beverages

Taro leaves extract (TLE) was used to manufacture two fermented milk beverages in concentrations of 250 and 500 mg/L (FMTLE 250 and FMTLE 500). The polyphenolic profile via HPLC, volatile compounds via GC-MS, antioxidant, antimicrobial activities of TLE, physicochemical properties, probiotic survival, and bioaccessibility of the supplemented beverages were also evaluated. TLE presented phenolic and flavonoid levels of 130.56 ± 1.55 μg GAE/g and 53 ± 1.15 CE μg/g, respectively. Sulfated polysaccharides, triterpenoids, and tannins were recorded (26.5 ± 0.8 μg/g, 7.30 ± 0.37 μg/g, 0.26 ± 0.03 μg/g). IC50 of the TLE measured using DPPH. assay was 144.83 ± 2.19 μg/mL, while the ABTS*+ assay was 100.48 ± 1.45 for determination antioxidant activity. The highest antimicrobial activity of TLE was observed against Salmonella enterica and Listeria monocytogenes with an inhibition zone of 15.5 and 13.6 mm, respectively. The survival of Lactobacillus paracasei showed no statistical difference between the control and FMTLE 250 and FMTLE 500 (P > 0.05). Antioxidant potential increased, with probiotics were stable through the digestion processes of the supplemented beverages and the increasing polyphenol concentration in the beverages. Sensory evaluation showed the acceptance of FMTLE 250 and FMTLE 500 for consumer consumption. In sum, combining TLE and probiotics in fermented beverages provides an excellent food model with many health benefits.Universidade de Vigo/CISU

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Inhibition of the SARS-CoV-2 RNA-Dependent RNA polymerase by natural bioactive compounds: Molecular docking analysis

Currently, no approved treatment for COVID-19 exists. However, phenolic compounds exhibit antiviral activity. This study aimed to evaluate the activities of polyphenolic compounds (gallic acid, quercetin, caffeine, resveratrol, naringenin, benzoic acid, oleuropein, and ellagic acid) as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA-dependent RNA polymerase (PDB ID 6M71) inhibitors. Molecular docking simulations of these polyphenols were performed using Autodock 4.0 and Chimera 1.8.1. Drug-likeness and pharmacokinetic properties were calculated using the SWISSADME prediction website. Remdesivir and ribavirin were used for comparison. The docking analysis results, ranked by the binding energy value (ΔG) of the tested ligands toward SARS-CoV-2 polymerase, were remdesivir > gallic acid > quercetin > caffeine > ribavirin > resveratrol > naringenin > benzoic acid > oleuropein > ellagic acid, with binding energies of −8.51, −7.55, −7.17, −6.10, −6.01, −5.79, −5.69, −5.54, −4.94, and −4.59 kcal/mol, respectively. All tested polyphenols were predicted to form hydrogen bonds with one or two of the nucleotide triphosphate (NTP) entry channels at ARG 553, ARG 555, or LYS 545, except caffeine and oleuropein, which may influence the entry of substrate and divalent cations into the central active site cavity, thereby inhibiting enzyme activity. It appears promising that gallic acid and quercetin exhibited higher binding affinity than ribavirin toward the SARS-CoV-2 polymerase and expressed good drug-likeness and pharmacokinetic properties. Additionally, resveratrol, naringenin, and benzoic and ellagic acids exhibited some efficacy as potential polymerase inhibitors. Further research is required to investigate the potential uses of these polyphenols in the treatment of COVID-19

<i>Lacticaseibacillus</i> <i>paracasei</i> KC39 Immobilized on Prebiotic Wheat Bran to Manufacture Functional Soft White Cheese

In the current study, probiotic Lacticaseibacillus paracasei KC39 was immobilized on wheat bran as a carrier. The immobilized synbiotic biocatalyst was freeze-dried and used as an adjunct during the production of functional soft white cheese. Free freeze-dried Lc. paracasei cells as an adjunct and a control cheese with a commercial starter were used for comparison. In addition to a fiber content of 1.12%, the functional cheese made using the synbiotic biocatalyst showed higher cell viabilities in the gastric and intestinal phases as well as an enhanced microstructure and favorable sensory characteristics. The presented immobilization method could be applied to the production of soft cheese and other functional food products for the stabilized delivery of both probiotics and dietary fibers

Lacticaseibacillus&nbsp;paracasei KC39 Immobilized on Prebiotic Wheat Bran to Manufacture Functional Soft White Cheese

In the current study, probiotic Lacticaseibacillus&nbsp;paracasei KC39 was immobilized on wheat bran as a carrier. The immobilized synbiotic biocatalyst was freeze-dried and used as an adjunct during the production of functional soft white cheese. Free freeze-dried Lc. paracasei cells as an adjunct and a control cheese with a commercial starter were used for comparison. In addition to a fiber content of 1.12%, the functional cheese made using the synbiotic biocatalyst showed higher cell viabilities in the gastric and intestinal phases as well as an enhanced microstructure and favorable sensory characteristics. The presented immobilization method could be applied to the production of soft cheese and other functional food products for the stabilized delivery of both probiotics and dietary fibers

Probiotic potential of lactic acid bacteria isolated from honeybees stomach: Functional and technological insights

Probiotic lactic acid bacteria (LAB) have garnered substantial attention for their potential health benefits, particularly in supporting the balance of gut microbiota. This study sought to assess LAB isolates from honeybees stomach as potential probiotics by evaluating their tolerance to acid and bile, autoaggregation, hydrophobicity, co-aggregation with pathogens, antioxidant activity, haemolysis, exopolysaccharide (EPS) production, in vitro cell adherence, and their performance in milk-based fermented products. The LAB isolates exhibited impressive resilience to gastric acid, surviving exposure to simulated gastric juice at pH 2 after 2 h of incubation. Autoaggregation and hydrophobicity, crucial for probiotic adhesion to intestinal epithelial cells, were observed in several LAB isolates. Notably, Ehb3, Ehb5, and Ehb8 displayed the highest values, indicating their potential for effective intestinal adhesion. The antioxidant activities of intracellular and cell-free lactic acid bacteria strain extracts were evaluated using DPPH (2,2-Diphenyl-1-picrylhydrazyl) and ABTS (2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) radical scavenging tests. Ehb3 and Ehb5 demonstrated outstanding antioxidant capabilities, suggesting their potential for enhancing the shelf life and health benefits of probiotic products. These lactic acid bacteria strains were also proficient in fermenting milk, maintaining viability above the technological requirements for probiotic products during storage. Finally, lactic acid bacteria isolate from honey bee stomach exhibit promising characteristics that make them suitable candidates for potential probiotics with health benefits

Biopreservative and Anti-Mycotoxigenic Potentials of <i>Lactobacillus paracasei</i> MG847589 and Its Bacteriocin in Soft White Cheese

Probiotics and their bacteriocins have increasingly attracted interest for their use as safe food preservatives. This study aimed to produce soft white cheese fortified with Lacticaseibacillus MG847589 (Lb. paracasei MG847589) and/or its bacteriocin; cheese with Lacticaseibacillus (CP), cheese with bacteriocin (CB), and cheese with both Lacticaseibacillus and bacteriocin (CPB) were compared to control cheese (CS) to evaluate their biopreservative and anti-mycotoxigenic potentials for prolonged shelf life and safe food applications. The effects of these fortifications on physiochemical, microbial, texture, microstructure, and sensory properties were studied. Fortification with Lacticaseibacillus (CP) increased acidity (0.61%) and microbial counts, which may make the microstructure porous, while CPB showed intact microstructure. The CPB showed the highest hardness value (3988.03 g), while the lowest was observed with CB (2525.73 g). Consequently, the sensory assessment reflected the panelists’ preference for CPB, which gained higher scores than the control (CS). Fortification with Lb. paracasei MG847589 and bacteriocin (CPB) showed inhibition effects against S. aureus from 6.52 log10 CFU/g at time zero to 2.10 log10 CFU/g at the end of storage, A. parasiticus (from 5.06 to 3.03 log10 CFU/g), and P. chrysogenum counts (from 5.11 to 2.86 log10 CFU/g). Additionally, CPB showed an anti-mycotoxigenic effect against aflatoxins AFB1 and AFM1, causing them to be decreased (69.63 ± 0.44% and 71.38 ± 0.75%, respectively). These potentials can extend shelf life and pave the way for more suggested food applications of safe food production by fortification with both Lb. paracasei MG847589 and its bacteriocin as biopreservatives and anti-mycotoxigenic

Validation of New ELISA Technique for Detection of Aflatoxin B1 Contamination in Food Products versus HPLC and VICAM

Toxin-contaminated foods and beverages are a major source of illness, may cause death, and have a significant negative economic impact worldwide. Aflatoxin B1 (AFB1) is a potent toxin that may induce cancer after chronic low-level exposure. This study developed a quantitative recombinant AflR gene antiserum ELISA technique for aflatoxin B1 detection in contaminated food products. Aflatoxin B1 residuals from 36 food samples were analyzed with HPLC and VICAM. DNA was extracted from aflatoxin-contaminated samples and the AflR gene amplified using PCR. PCR products were purified and ligated into the pGEM-T vector. Recombinant plasmids were sequenced and transformed into competent E. coli (BL21). Molecular size and B-cell epitope prediction for the recombinant protein were assessed. The purified protein was used to induce the production of IgG antibodies in rabbits. Serum IgG was purified and labeled with alkaline phosphatase. Finally, indirect-ELISA was used to test the effectiveness of polyclonal antibodies for detection of aflatoxin B1 in food samples