ABSTRACT
Burkholderia pseudomallei is soil saprophytic Gram-negative bacilli that cause a fatal disease called melioidosis. Melioidosis is capable of causing cutaneous infection and systemic infections in the respiratory tract, cardiovascular, gastrointestinal, urinary, skin and soft tissue, and musculoskeletal and central nervous systems. Here, we report rare forms of pulmonary, cerebral, and splenic abscess case series of melioidosis caused by B. pseudomallei. Imported cases have been reported among tourists, immigrants, and soldiers who returned from endemic areas. The acquisition of infection is through percutaneous, inhalation, and ingestion of contaminated water;person-to-person transmission is very rare. Melioidosis cases are primarily found in the rainfall season and are usually associated with risk factors such as diabetes, alcoholism, and chronic renal diseases. However, 20-26% of cases were not associated with predisposing conditions. The identification is based on colony morphology, Gram stain, antibiotic susceptibility testing, and other supportive automated and molecular assays when we suspect B. pseudomallei. There are two phases, the intensive and eradication phases, in managing melioidosis. In the intensive phase, ceftazidime for 2 weeks showed efficacy in almost 50% of cases, and the eradication phase treatment with co-trimoxazole and doxycycline or amoxicillin/clavulanic acid for 3-6 months showed an excellent response. The improper clinical diagnosis and management of B. pseudomallei can lead to complications. Hence, early diagnosis with microbiological approaches such as culture, biochemical reactions, or automated systems available and antimicrobial sensitivity testing will cure the patient quickly without mortality.Copyright © 2023 The Authors.
ABSTRACT
The Ukrainian confectionery market has always been competitive one as Ukraine is the global trader of different confectionery products. But this market has been affected by the COVID-19 pandemic and socio-economic crisis, decreased customer purchasing power and rise in prices caused by it;large-scale changes in this sector and the market redistribution have resulted from this crisis. The aim of research was to conduct a detailed study of the Ukrainian confectionery market due to COVID-19 pandemic affect for the new consumer needs, market trends and perspectives defining. In order to do this, we made the significant analytical research using database of the State Statistics Service of Ukraine and worldwide analytical resources regarding the capacity of the Ukrainian confectionery market and its segments, which was calculated, and capacity dynamics analysis provided. The segments of the confectionery market were examined in detail, and their dynamics features were investigated. As the result of an accurate statistical and economic analysis (by gathering and structuring public data arrays, using grouping and comparison methods, method of dynamics series analysis and others), the chocolate bar product category was determined as one with the highest development potential. Thus, the chocolate bar product category was investigated in the terms of the market competition (particularly for their brands development and current companies' market positions), the existing product ranges and the digital marketing tools used by the key competitors. As the result of our research, we got the detailed dynamics report on the Ukrainian confectionery market indicators and COVID-19 pandemics impact on its development. We forecasted a gradual growth for this market at least for 10.4% throughout 2022-2025 (despite the temporary market losses), that will be gained by a high growth rate (22.6%) of the chocolate products segment. Taking everything into account, we estimated the key trends in the chocolate bar category, which are going to be the confectionery market drivers for a long time, namely: the sugar content and other unhealthy ingredients reduction, the permanent consumption of traditionally flavoured products, the weight of chocolate bar reduction (the most sold formats will be 100 g, 90 g and 85 g), an increase loyalty to the domestic producer and others. This research results provide a great opportunity for local and foreign confectionery companies to upgrade their brands strategies and production plans according to the defined consumer needs, estimated key features of confectionery segments` development and forecasted market changes. © 2023, Consulting and Training Center - KEY. All rights reserved.
ABSTRACT
The COVID-19 pandemic, unleashed at the end of 2019, seriously affected not only the health of thousands of Peruvians but also the economy and production systems. This is reflected in the reduction of the GDP, which during that year suffered a reduction of 11.12%. Regarding the chocolate industry, consumption, production, and importation were growing in previous years, but had a significant decrease during 2020. Due to government sanitary restrictions, many Peruvian businesses were forced to keep their inventory on hand almost all year. Despite the fact that some experts affirm that it is convenient to maintain a greater number of inventories when there is dynamism in the labor market, it is very risky to keep such levels of stocks permanently. In the present investigation, an inventory management improvement model is proposed using the DDMRP and PA techniques, with which the optimal quantities to be produced and kept in inventories will be determined at the different levels of the supply chain. In this way, the impact generated by the Inventory Maintenance Cost (IMC) will be reduced, and the Inventory Turnover Ratio (ITR) will be increased to 3.2. The model will be validated by simulation to verify that the levels are optimal for the system. © 2022 ACM.
ABSTRACT
Purpose>Immersive virtual reality (IVR) has been frequently proposed as a promising tool for learning. However, researchers have commonly implemented a plethora of design elements in these IVR systems, which makes the specific aspects of the system that are necessary to achieve beneficial outcomes unclear. Against this background, this study aims to combine the literature on presence with learning theories to propose that the ability of IVR to present 3D objects to users improves the presence of these objects in the virtual environment compared with 2D objects, leading to increased learning performance.Design/methodology/approach>To test this study's hypotheses, the authors conducted a 2 (training condition: approach vs avoid) x 2 (object presence: high vs low) between-subjects laboratory experiment that used IVR with 83 female participants.Findings>The results support this study's hypotheses and show that training with high object presence leads to greater reactions to cues (chocolate cravings) and improved health behaviour (chocolate consumption).Originality/value>This study shows that increased object presence leads to unique experiences for users, which help reinforce training effects. Moreover, this work sheds further light on how immersive computer technologies can affect user attitudes and behaviour. Specifically, this work contributes to IVR research by showing that learning effects can be enhanced through an increased degree of object presence.
ABSTRACT
This research measured consumers’ emotions and change in emotion to the specific sensory taste properties and attitudes of chocolate-based biscuits. The sample size involved 216 respondents from South Africa (n = 106) and Switzerland (n = 110). Respondents tasted chocolate-based biscuits and completed an online questionnaire. The increase in consumers’ levels of guilt after chocolate-based biscuit consumption and the contribution of a chocolate taste and craving attitude to consumers’ subsequent positive emotions and change in positive emotions could help food and consumer scientists to understand the link between emotions and the sensory descriptors of chocolate-based biscuits. Investigating the association between the emotional responses and sensory attributes of sweet baked products could benefit product developers when formulating food products for specific target markets and aid in the understanding of the emotional profile of food products.
ABSTRACT
Background: Schools play a vital role in childhood nutrition. Months into the COVID-19 pandemic, 21 million free meals were distributed by Chicago Public Schools (CPS). Cardiovascular (CV) risk factors begin in childhood and school meals establish healthy eating patterns. To our knowledge, school meal nutrition has not been studied from a CV disease prevention perspective. Guidelines published by the National Heart, Lung, and Blood Institute (NHLBI) in 2012 strongly recommend that 2-21-yearolds consume <30% of calories/day from fat, <10% of calories/day from saturated fat, and <300 mg of cholesterol/day to promote CV health in adolescence. As CPS currently follows USDA nutrition guidelines, we sought to determine the alignment of school meals for K-8th graders with NHLBI recommendations. Methods: May and June 2021 CPS breakfasts and lunches were analyzed. Menus were obtained from the CPS website and nutrition information from a school nutritionist. Total breakfast and lunch calories, calories from fat, calories from saturated fat, and mg of cholesterol were recorded. The percent of daily caloric intake from fat and saturated fat was calculated. Days that cholesterol content exceeded 200 mg (2/3 of daily recommended) were analyzed as we examined 2/3 of daily meals. The effect of milk (skim, chocolate skim, or 1%) was considered. The number of meals meeting NHLBI guidelines were counted, and the percentage of meals meeting standards were calculated with 95% confidence intervals. Results: CPS meals met the standards for total fat, saturated fat, and cholesterol on 62%, 60%, and 78% of days, respectively with median values meeting NHLBI standards. When factoring milk consumption, skim and chocolate milk respectively add 85 and 115 calories with no fat and 5 mg cholesterol. Both of these milk choices improve compliance with total and saturated fat standards while having a negligible impact on the cholesterol standard. 1% milk adds 105 calories at the expense of 27 calories of fat, 18 calories of saturated fat, and 15 mg of cholesterol. This milk has minimal impact on the total fat standard and total cholesterol standards but a negative impact on the saturated fat standard. Cholesterol results are greatly impacted by eggs. On all the days where total cholesterol exceeded 200 mg, hardboiled eggs were served at breakfast. Conclusion: Over the last several decades, the nutritional quality of school meals has vastly improved. Specifically, CPS is a leader in nutrition standards and has made monumental strides to improve school meals. As a program federally funded by the National School Lunch Program, CPS represents many other qualifying schools. While CPS currently exceeds the USDA guidelines it is expected to comply with, the rates of compliance with NHLBI guidelines suggest there is room for improvement. Current guidelines may want to consider implementing standards specific to CV health promotion. (Left). Proportion of active IEP initiated and/or managed by RHCSP education liaisons by diagnosis. Values listed represent N, percentage (%). Figure 1b (Right). Proportion of active 504 initiated and/or managed by RHCSP education liaisons by diagnosis. Values listed represent N, percentage (%).
ABSTRACT
Introduction: A single tertiary care center has offered oral immunotherapy (OIT) as a clinical service since 2018 using commercial products and subsequently has offered FDA-approved Peanut (Arachis- hypogaea) Allergen Powder-dnfp (PNAP) since July 2020. Shared decision making regarding OIT was based on previous IgE testing, history, and family preference. Methods: A retrospective chart review was performed in REDCap database. Results: A total of 37 patients initiated OIT (21 commercial products and 16 PNAP). The mean age was 9.25 for commercial product and 7.25 for PNAP with more males than females participating. Co-morbid conditions included allergic rhinitis, asthma, and eczema. Mean peanut IgE prior to starting was 49.75 and Ara h2 was 32.73. Prior reactions to peanut included skin, GI and anaphylaxis. Three children failed an oral challenge prior to starting OIT. There were 5 children that had never ingested peanuts but completed OIT. Minor intermittent side effects including stomach upset and itchy mouth were reported during escalation of both products. Dose adjustment was required for 1 PNAP patient for complaint of dysphagia and pain. There were 4 patients who dropped out of OIT: refusal to eat (1), unrelated GI disease (1) and the COVID-19 pandemic (2). All patients upon reaching maintenance are daily dosing with peanuts or chocolate-covered peanut candy. Lifestyle changes reported since reaching maintenance include eating in restaurants previously avoided and ingesting foods with labels stating: “may contain peanuts,” and “foods processed in a facility with peanuts.” Conclusions: Peanut OIT is safe and well tolerated in our patient population.
ABSTRACT
INTRODUCTION: The diagnosis of methemoglobinemia is infrequently thought of in cases of hypoxia, given its rarity. The most common inciting factor is an exposure to oxidizing agents, such as various antibiotics (sulfonamides, trimethoprim, and dapsone), local anesthetics, nitrites, and aniline dyes. This is a case of methemoglobinemia in a patient who was initially treated for COVID 19 with outpatient vitamin infusions. DESCRIPTION: A 76-year-old man was brought to the emergency department after collapsing at home. He was treated for COVID-19 the week prior with ivermectin and vitamin infusions, however developed high fevers, up to 102 F, with worsening cough and fatigue. On arrival his oxygen saturation was 50%, which improved with non-rebreather. Chest CT revealed multifocal ground glass opacities, consistent with COVID pneumonia. Shortly after admission, a rapid response was initiated as the patient was becoming more hypoxic with worsening altered mental status. Pulse oximetry revealed oxygen saturation of 60%;the patient was quickly intubated and transferred to the intensive care unit - oxygen saturation continued to read 70% despite a FiO2 100%. An arterial blood gas appeared brown in color and revealed a normal paO2 and pCO2. The patient was found to have a methemoglobin level of 21%. The patient underwent exchange transfusion of 7 units, with subsequent resolution of his hypoxia. DISCUSSION: Methemoglobinemia is a life threatening disorder, and diagnosis is dependent on a high degree of clinical suspicion. Patients typically present with shortness of breath, fatigue, cyanosis, and can ultimately develop loss of consciousness. An arterial blood gas, with its classic chocolate-brown appearance, a normal Po2, and CO-oximetry panel confirms diagnosis. Methemoglobinemia is routinely treated with methylene blue and, in severe cases, requires red cell exchange. There are reports that have shown benefits of high-dose vitamin C for safe and effective treatment of methemoglobinemia in centers with no access to methylene blue, through its anti-oxidant effect. Interestingly, this patient developed this condition after being treated for COVID 19 with vitamin infusions. This case highlights the importance of careful history taking, as certain medications can have unknown and fatal side effects.
ABSTRACT
Background: Fathers play an important role in child development but are rarely included in research on the parental determinants of child eating behavior. This omission requires addressing, particularly in the context of the COVID-19 pandemic, during which families spent more time at home and thus more time together for meals and snacks. Previous research in mothers suggests providing structure around children's eating may be beneficial for child eating behavior. We aimed to investigate associations of fathers' reports of provision of structure around children's eating during the pandemic with child eating behavior and diet during the pandemic. Methods: Fathers (N = 112) of 2-12- year- old children completed an online survey in May/June 2020 including questions on structure-related food parenting practices (e.g. insist child eats at table, not allowing child to wander around during meal, father decides timing of meal), child eating behaviors (emotional overeating [EOE], food responsiveness [FR]), and child diet. Correlations and path models were used to examine individual and simultaneous relationships. Results: A third of the sample was more likely to eat meals together compared to before the pandemic. Structure-related food parenting practices were significantly negatively associated with EOE (β = -. 434, p = .004) but not FR (β = -. 227, p = .132). EOE was significantly positively correlated with children's sweet and savory snack intake (e.g. chocolate, cookies/cake, donuts, ice cream, low-fat chips, savory snacks;rho = .244 to .504) as well as fast food intake (rho = .432). Conclusions: Our results suggest that fathers' provision of structure around children's eating during the pandemic may be associated with lower levels of obesity-associated eating behaviors in their children, which could contribute to healthier profiles of food intake and body weight.
ABSTRACT
We report to use the main protease (Mpro) of SARS-Cov-2 to screen plant flavan-3-ols and proanthocyanidins. Twelve compounds, (-)-afzelechin (AF), (-)-epiafzelechin (EAF), (+)-catechin (CA), (-)-epicatechin (EC), (+)-gallocatechin (GC), (-)-epigallocatechin (EGC), (+)-catechin-3-O-gallate (CAG), (-)-epicatechin-3-O-gallate (ECG), (-)-gallocatechin-3-O-gallate (GCG), (-)-epigallocatechin-3-O-gallate (EGCG), procyanidin A2 (PA2), and procyanidin B2 (PB2), were selected for docking simulation. The resulting data predicted that all 12 metabolites could bind to Mpro. The affinity scores of PA2 and PB2 were predicted to be -9.2, followed by ECG, GCG, EGCG, and CAG, -8.3 to -8.7, and then six flavan-3-ol aglycones, -7.0 to -7.7. Docking characterization predicted that these compounds bound to three or four subsites (S1, S1', S2, and S4) in the binding pocket of Mpro via different spatial ways and various formation of one to four hydrogen bonds. In vitro analysis with 10 available compounds showed that CAG, ECG, GCG, EGCG, and PB2 inhibited the Mpro activity with an IC50 value, 2.98 ± 0.21, 5.21 ± 0.5, 6.38 ± 0.5, 7.51 ± 0.21, and 75.3 ± 1.29 µM, respectively, while CA, EC, EGC, GC, and PA2 did not have inhibitory activities. To further substantiate the inhibitory activities, extracts prepared from green tea (GT), two muscadine grapes (MG), cacao, and dark chocolate (DC), which are rich in CAG, ECG, GAG, EGCG, or/and PB2, were used for inhibitory assay. The resulting data showed that GT, two MG, cacao, and DC extracts inhibited the Mpro activity with an IC50 value, 2.84 ± 0.25, 29.54 ± 0.41, 29.93 ± 0.83, 153.3 ± 47.3, and 256.39 ± 66.3 µg/ml, respectively. These findings indicate that on the one hand, the structural features of flavan-3-ols are closely associated with the affinity scores; on the other hand, the galloylation and oligomeric types of flavan-3-ols are critical in creating the inhibitory activity against the Mpro activity.
ABSTRACT
The craft chocolate and specialty cacao industry has been driving the global chocolate industry towards more sustainable farming and ethical and transparent sourcing practices by prioritizing farmer welfare, environmental resource conservation, and consumer education. However, the craft chocolate and specialty cacao industries are also uniquely vulnerable to the immediate and long term impacts of the COVID-19 pandemic, and many cacao producers are expected to be disproportionately affected. Craft chocolate businesses have been especially hard hit by losses in revenue and specialty cacao producers are facing unique challenges compared to their industrial counterparts. Factors that influence the future of these businesses include: labor intensity, regional politics, risk tolerance, and accessibility. Immediate impacts include loss of revenue and access to markets, which are directly influenced by travel restrictions, access to petrol, global trade networks, and operational limitations. Long term impacts include changes in business strategies, including the use of e-commerce, elevating consumer education to sustain sales and providing access to transparent pricing. The global crisis reveals that there is an ethical imperative to provide investments in the specialty cacao and craft chocolate industry to deliver farmer relief, improve access to technology for business needs, and support farmer empowerment in negotiations to mitigate risks.
ABSTRACT
Fluid dairy milk consumption has decreased over the last 4 decades, and this drop has accelerated with the introduction of many competing beverage alternatives, such as plant-based milks and bottled water. Conversely, flavored milk sales remain strong, but many adults avoid flavored milk because of concerns about added sugar and calories and/or excessive sweetness. Here we used two discrete choice experiments to assess interest for a dark chocolate milk drink in adults, and explored whether there might be a consumer segment who prefers a more bitter, lower sugar chocolate milk. Adults were recruited from the Mid-Atlantic region of the United States for two conjoint analysis studies. In a general population cohort (n = 735), type of sweetener was the most important attribute (24%), followed by milk fat (19%), grams of added sugar (16%), front of pack messaging (15%), package type (12%), carton size (8%), and protein content (6%). Attribute importance was relatively consistent in a second study with a younger, more physically active cohort (n = 1017). Product choices in the active cohort were related to orthorexia and physically activity scores, indicating revealed preferences in a choice task are reflective of personal lifestyle and eating behavior. In both cohorts, three consistent consumer segments were identified and characterized: the calorie conscious, the average consumer, and the natural eaters. These data can help uncover lifestyle differences between adult consumers that impact their food product choices.