Characterisation and application of fruit by-products as novel ingredients in gluten-free products

Doctoral ThesisLiterature has revealed that “waste” left from the processing of fruit can still contain a substantial quantity of macro and minor nutrients. The aim of this thesis was to ascertain the nutritional and structural properties and potential uses of two fruit by-products [apple pomace (Malus domestica Cv. “Karmijn de Sonnaville”) and orange pomace (Citrus sinensis L. Cv. “Valencia”)] in glutenfree bread and extruded snack formulations. The physicochemical and nutritional properties of the fruit by-products were initially studied. Apple pomace contained a high level of fibre and pectin. The isolated pectin was demonstrated to have a high level of methylation which developed viscous pastes. Orange pomace also had high levels of fibre and pectin, and it was an abundant source of minerals such as potassium and magnesium. Orange pomace had a poor gelling ability. The flour obtained after milling dried orange pomace was used in the formulation of gluten-free bread with the aid of a response surface design. Due to the fibrous properties of orange pomace flour, proofing and water addition were also studied. When added at levels greater than 6%, the loaf volume decreased. The number of cells per slice also decreased with increasing orange pomace addition. Inclusion of orange pomace at levels of up to 4% increased crumb softness. An optimised formulation and proofing time was derived using the optimisation tool; these consisted of 5.5% orange pomace, 94.6% water inclusion and with 49 minutes proofing. These optimised parameters doubled the total dietary fibre content of the bread compared to the original control. The pasting properties, rheology, microstructure and sensory characteristics of the optimised formulation (batter and bread) were investigated. Pasting results showed how orange pomace inclusions reduced the final viscosity of the batter, hence reducing the occurrence of starch gelatinisation. Rheological properties such as the storage modulus (G') and complex modulus (G*) increased in the orange pomace batter compared to the control batter. This demonstrates how the orange pomace as an ingredient improved the robustness of the formulation. Sensory panellists scored the orange pomace bread comparably to the control bread. Milled apple pomace was studied as a potential novel ingredient in an extruded snack. As extrusion requires the trialling of a number of extruder parameters, a response surface design was again used to develop an optimised snack. The parameters studied were apple pomace addition, die head temperature and screw speed. Screw speed had the most significant impact on extrudate characteristics. As screw speed increased the favourable extrudate characteristics such as radical expansion ratio, porosity and specific volume decreased. The inclusion of apple pomace had a negative effect on extrudate characteristics at levels greater than 8% addition. Including apple pomace reduced the hardness and increased the crispiness of the snack. Using the optimisation tool, the optimised and validated formulation and extrusion process contained the following parameters: 7.7% apple pomace, 150oC die head temperature and a screw speed of 69 rpm.Department of Agriculture, Food and the Marin

Evaluation of a fluorescence and infrared backscatter sensor to monitor acid induced coagulation of skim milk

peer-reviewedA prototype sensor that employs both ultraviolet excited fluorescence and infrared light backscatter was evaluated as an in-line process analytical technology (PAT) tool to monitor acid induced coagulation kinetics of skim milk. Coagulation experiments were carried out at 32 °C using three concentrations of glucono-delta-lactone (GDL). Measurement of storage modulus (G′) of acidified skim milk gel was used as a reference rheological method to monitor the coagulation kinetics. Prediction models were developed to predict the times required for acidified skim milk coagulum to reach selected G′ values (0.5 Pa, 1 Pa, 5 Pa, 10 Pa and 15 Pa) using time parameters extracted from the ultraviolet excited fluorescence and infrared light backscatter profiles. A strong correlation was observed between the predicted times developed using time parameters extracted from the prototype sensor profiles and the measured G′ times extracted from the rheometer (R2 = 0.97, standard error of prediction = 2.8 min). This study concluded that the prototype fluorescence and infrared backscatter sensor investigated combined with the developed rheological prediction model can be used as a potential PAT tool for in-line monitoring of coagulation kinetics in the manufacture of acid induced milk gels. Industrial relevance: The prototype fluorescence and infrared backscatter sensor investigated in this study combined with the developed rheological prediction model can be employed to monitor and control coagulation kinetics in a wide range of dairy processing applications including fresh cheese varieties and yoghurt manufacture

Review of near-infrared spectroscopy as a process analytical technology for real-time product monitoring in dairy processing

peer-reviewedReal-time process/product monitoring can be achieved using suitable process analytical technologies (PAT) to improve process efficiencies and product quality. In the dairy industry, near infrared (NIR) spectroscopy has been utilised as a laboratory analytical method (off-line) for compositional analysis of dairy products since the 1970s. Recent advances in NIR technology and instrumentation have widened its applications from a bench-top analytical instrument to a promising PAT tool for on-line and in-line implementation. This review focuses on the use of NIR technology for real-time monitoring of dairy products, by briefly outlining the measurement principle, NIR instrument configurations, in-line sampling methods, calibration models development, some practical considerations for process installation, and current state of the art in on-line and in-line NIR applications (2012 to date) for continuous process monitoring in the production of dairy products. The challenges and additional resources required to improve production efficiencies using NIR spectroscopy are also discussed.Dairy Processing Technology Centre (DPTC) and Enterprise Irelan

Fate of beta-glucan, polyphenols and lipophilic compounds in baked crackers fortified with different barley-milled fractions

peer-reviewedFour types of crackers were prepared, whereby wheat flour was substituted with different percentages of barley flour and bran. These formulations were compared to a 100% wheat flour (control) cracker with respect to β-glucan, polyphenols and lipophilic bioactives. Incorporation of barley fractions enriched the β-glucan, and phenolic content, as well as in vitro antioxidant capacities of the crackers. However, some polyphenols including procyanidin C and ferulic acid could not be detected in the crackers owing to the probable degradation of these compounds during baking. The β-glucan, flavanols (catechin and procyanidin B), as well as fatty acids and sterols were least affected; while the α-tocotrienols showed degradation following the baking process. Overall, barley fractions can serve as valued ingredients for enhancing the health-salutary components of fortified crackers or the products thereof

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

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

Evaluation of rennet-induced gelation under different conditions as a potential method for 3D food printing of dairy-based high-protein formulations

peer-reviewedThe rennet-induced gelation of milk proteins was evaluated as a potential method for the formation of 3D printed food structures. The effects of pH, [Ca2+], and temperature on the rennet gelation properties of milk protein dispersion with 15% (w/w) protein content were assessed using low amplitude strain oscillation rheometry. A cycled-temperature ramp (heating-holding-cooling) during rheological measurements was suitable to evaluate gel firmness development, as an imitation of the temperature profile in the 3D printing process. A factorial design considering two levels of pH (6.0 and 6.4), [Ca2+] (1.5 and 5.7 mM), and temperature (31 and 40 °C), showed that the pH, temperature, and its interaction were the main factors enhancing gel formation and the strength of the resultant gel. At pH 6.0 and temperature ramped to 40 °C followed by cooling to 15 °C, a very high gel strength (~8–9 kPa) was obtained. These results showed that rennet-induced gelation could be manipulated for developing printable dairy formulations.Department of Agriculture, Food and the Marine, Irelan

Correlation between maternal inflammatory markers and fetomaternal adiposity

Outside pregnancy, both obesity and diabetes mellitus are associated with changes in inflammatory cytokines. Obesity in pregnancy may be complicated by gestational diabetes mellitus (GDM) and/or fetal macrosomia. The objective of this study was to determine the correlation between maternal cytokines and fetomaternal adiposity in the third trimester in women where the important confounding variable GDM had been excluded. Healthy women with a singleton pregnancy and a normal glucose tolerance test at 28 weeks gestation were enrolled at their convenience. Maternal cytokines were measured at 28 and 37 weeks gestation. Maternal adiposity was assessed indirectly by calculating the Body Mass Index (BMI), and directly by bioelectrical impedance analysis. Fetal adiposity was assessed by ultrasound measurement of fetal soft tissue markers and by birthweight at delivery. Of the 71 women studied, the mean maternal age and BMI were 29.1 years and 29.2 kg/m2 respectively. Of the women studied 32 (45%) were obese. Of the cytokines, only maternal IL-6 and IL-8 correlated with maternal adiposity. Maternal TNF-a, IL-b, IL-6 and IL-8 levels did not correlate with either fetal body adiposity or birthweight. In this well characterised cohort of pregnant non-diabetic women in the third trimester of pregnancy we found that circulating maternal cytokines are associated with maternal adiposity but not with fetal adiposity

Effects of introducing a secure web-based messenger application for communication among non-consultant hospital doctors

Use of web-based messaging applications to communicate clinical information is common between non-consultant hospital doctors (NCHDs). This study sought to assess webbased messenger use in NCHDs following the introduction of a more secure alternative to WhatsApp (WhatsApp, Inc., Menlo Park, CA, USA). Methods: A 10-item survey was undertaken on two NCHD cohorts. The second cohort received training on data protection and an alternative application to WhatsApp. Quantitative data analysis was conducted using the IBM Statistical Package for Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY). Results: The total response rate across both groups was 63% (N = 68). The majority of respondents used WhatsApp to communicate clinical information. In the second cohort, fewer NCHDs shared identifiable sensitive patient information 97% (n = 29/30) vs 81% (n = 25/31) and fewer NCHDs shared/stored clinical images. Discussion: WhatsApp use is common among NCHDs. An alternative means of communication can improve the safety of patient data. NCHDs require more training on data protection laws and their own responsibilities

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe