Feasibility and Acceptability of Standardizing Portions in Restaurants.

Most restaurants serve customers excess calories which significantly contributes to the obesity epidemic. This pilot study tested the feasibility and acceptability of offering customers standardized portions to reduce caloric consumption when dining out in three restaurants. Portions were developed to limit quantity of food served, with lunches and dinners ≤ 700 cal and breakfast ≤ 500 cal. Participating restaurants developed an alternative "Balanced Portions Menu." Training and instructions were provided with respect to the volume and weight of food to be plated following the standardized guidelines and providing at least one cup of vegetables per lunch/dinner. We invited local residents to help us evaluate the new menu. We monitored restaurant adherence to guidelines, obtained feedback from customers, and incentivized customers to complete dietary recalls to determine how the new menus might have impacted their daily caloric consumption. Of the three participating restaurants, all had a positive experience after creating the new menus and received more foot traffic. One restaurant that did not want to change portion sizes simply plated the appropriate amount and packed up the rest to-go, marketing the meals as "Dinner today, lunch tomorrow." Two of the restaurants followed the guidelines precisely, while one sometimes plated more rice than the three-fourths cup that was recommended. A significant number of customers ordered from the Balanced Portions menus. Two of the three restaurants have decided to keep offering the Balanced Portions menus indefinitely. Following standardized portions guidelines is both feasible for restaurants and acceptable to customers.

An Affordable and Sustainable Thrifty-Like Meal Plan, FoodRx, That Meets the Recommended Dietary Allowances.

There is considerable controversy as to whether a healthy diet is affordable given recent inflation. In order to determine whether a healthy, climate-friendly sustainable diet can be obtained within the allotments of the Supplemental Nutrition Assistance Program (SNAP), we created and purchased 26 weeks of meal plans designed to meet the EAT-Lancet sustainability guidelines and > 90% of the RDAs for 23 macro/micronutrients for households with at least 2 adults and 1-3 children. We compared the food quantities and cost of a healthy sustainable diet purchased in Los Angeles, 2023, to the Thrifty Food Plan, 2021. We compared the volume of food and cost of basic groceries to those recommended in the Thrifty Food Plan, 2021. The costs of the sustainable diet fell within the 2023 SNAP allotments as long as the average calories required per person did not exceed 2000. The volume of fruits, vegetables, legumes, nuts, and seeds were considerably higher for the sustainable diet compared to the Thrifty Food Plan. Given that calorie needs are the determinants of food quantity and costs, the USDA may consider offering supplemental coverage for individuals with higher calorie needs to make healthy eating affordable.

Electrochemical degradation of surfactants in domestic wastewater using a DiaClean® cell equipped with a boron-doped diamond electrode.

Treating domestic wastewater has become more and more complicated due to the high content of different types of detergents. In this context, advanced electro-oxidation (AEO) has become a powerful tool for complex wastewater remediation. The electrochemical degradation of surfactants present in domestic wastewater was carried out using a DiaClean® cell in a recirculation system equipped with boron-doped diamond (BDD) as the anode and stainless steel as the cathode. The effect of recirculation flow (1.5, 4.0 and 7.0 L min-1) and the applied current density (j = 7, 14, 20, 30, 40, and 50 mA cm-2) was studied. The degradation was followed by the concentration of surfactants, chemical oxygen demand (COD), and turbidity. pH value, conductivity, temperature, sulfates, nitrates, phosphates, and chlorides were also evaluated. Toxicity assays were studied through evaluating Chlorella sp. performance at 0, 3, and 7 h of treatment. Finally, the mineralization was followed by total organic carbon (TOC) under optimal operating conditions. The results showed that applying j = 14 mA cm-2 and a flow rate of 1.5 L min-1 during 7 h of electrolysis were the best conditions for the efficient mineralization of wastewater, achieving the removal of 64.7% of surfactants, 48.7% of COD, 24.9% of turbidity, and 44.9% of mineralization analyzed by the removal of TOC. The toxicity assays showed that Chlorella microalgae were unable to grow in AEO-treated wastewater (cellular density: 0 × 104 cells ml-1 after 3- and 7-h treatments). Finally, the energy consumption was analyzed, and the operating cost of 1.40 USD m-3 was calculated. Therefore, this technology allows for the degradation of complex and stable molecules such as surfactants in real and complex wastewater, if toxicity is not taken into account.

Development and Characterization of Electrospun Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) Biopapers Containing Cerium Oxide Nanoparticles for Active Food Packaging Applications.

Food quality is mainly affected by oxygen through oxidative reactions and the proliferation of microorganisms, generating changes in its taste, odor, and color. The work presented here describes the generation and further characterization of films with active oxygen scavenging properties made of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) loaded with cerium oxide nanoparticles (CeO2NPs) obtained by electrospinning coupled to a subsequent annealing process, which could be used as coating or interlayer in a multilayer concept for food packaging applications. The aim of this work is to explore the capacities of these novel biopolymeric composites in terms of O2 scavenging capacity, as well as antioxidant, antimicrobial, barrier, thermal, and mechanical properties. To obtain such biopapers, different ratios of CeO2NPs were incorporated into a PHBV solution with hexadecyltrimethylammonium bromide (CTAB) as a surfactant. The produced films were analyzed in terms of antioxidant, thermal, antioxidant, antimicrobial, optical, morphological and barrier properties, and oxygen scavenging activity. According to the results, the nanofiller showed some reduction of the thermal stability of the biopolyester but exhibited antimicrobial and antioxidant properties. In terms of passive barrier properties, the CeO2NPs decreased the permeability to water vapor but increased the limonene and oxygen permeability of the biopolymer matrix slightly. Nevertheless, the oxygen scavenging activity of the nanocomposites showed significant results and improved further by incorporating the surfactant CTAB. The PHBV nanocomposite biopapers developed in this study appear as very interesting constituents for the potential design of new active organic recyclable packaging materials.

An exploration of customers' perceptions, preferences, experiences, and feasibility of offering standardized portions in restaurants.

Excess caloric intake increases the risk of weight gain, and diet-related chronic diseases. Restaurants play an integral role in the portions of food people consume. Standardization of portion sizes in restaurants can help customers recognize appropriate portions. Through customer interviews, we aimed to assess and understand the feasibility, perceptions, and acceptability of standardized portions in restaurants. Kaiser Permanente partnered with three restaurants in Southern California to create alternative menu options of meals that would not exceed 700 calories. Kaiser Permanente members who lived within a 5-mile radius of the restaurants were informed through email about the study. Customers (N=33), who dined at one of the restaurants participated in a one-on-one semi-structured interview. Interviews were recorded, typed, transcribed verbatim, and analyzed using thematic analysis. Four themes emerged from the analysis: 1) Customers perceive standard portions as a better choice and the benefits outweigh regular portions; 2) Individual and restaurant-related factors may influence portion preferences; 3) Restaurant portions are perceived to be in excess of what customers need; and 4) Portion standardization is an evolving area for restaurants. Our findings suggest positive perceptions and acceptance of standardized portions among restaurant customers. Customer awareness and restaurant standardization procedures can improve customers' dining experience.

Development of Multilayer Ciprofloxacin Hydrochloride Electrospun Patches for Buccal Drug Delivery.

Bacterial infections in the oral cavity can become a serious problem causing pain, sores and swelling for several weeks. This type of infection could be alleviated using mucoadhesive delivery systems, allowing local administration of the antibiotic to inhibit bacterial spreading. This work reports the development of a multilayer antibiotic patch containing ciprofloxacin hydrochloride (CPX)-loaded electrospun fibers for the treatment of such infections. For this, the release kinetics of the CPX-loaded fibers was modulated using different ratios of polyester blends. The selected reservoir layer was analyzed by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), wide angle x-ray scattering (WAXS) and differential scanning calorimetry (DSC). These analyses confirmed the presence and good distribution of the drug in the fibers and that the drug is in an amorphous state within the reservoir layer. To enhance mucoadhesion whilst ensuring drug directionality, the reservoir layer was assembled to a backing and an adhesive layer. This multilayer patch was assessed in terms of in vitro drug release, adhesion and antimicrobial properties. The multilayer strategy showed excellent antimicrobial properties over time and also a strong adhesion patch time in the volunteers for an average of 7 h. These results highlight the capabilities of multilayer electrospun patches as platforms to treat oral infections.

Antimicrobial Nanofiber Based Filters for High Filtration Efficiency Respirators.

Electrospinning has been used to develop and upscale polyacrylonitrile (PAN) nanofibers as effective aerosol filtration materials for their potential use in respirators. The fibers were deposited onto non-woven spunbond polypropylene (SPP) and the basis weight (grammage, g/m2) was varied to assess the resulting effect on filtration efficiency and breathing resistance of the materials. The results indicated that a basis weight in excess of 0.4 g/m2 of PAN electrospun fibers yielded a filtration efficiency over 97%, with breathing resistance values that increased proportionally with the amount of basis weight added. With the aim of retaining filter efficiency whilst lowering breathing resistance, the basis weight of 0.4 g/m2 and 0.8 g/m2 of PAN electrospun fibers were strategically split up and stacked with SPP in different configurations. The results suggested that a symmetric structure based on SPP/PAN/PAN/SPP was the optimal structure, as it reduces SPP consumption while maintaining an FFP2-type of filtration efficiency, while reducing breathing resistance, specially at high air flow rates, such as those mimicking FFP2 exhalation conditions. The incorporation of zinc oxide (ZnO) nanoparticles within the electrospun nanofibers in the form of nanocomposites, retained the high filtration characteristics of the unfilled filter, while exhibiting a strong bactericidal capacity, even after short contact times. This study demonstrates the potential of using the symmetric splitting of the PAN nanofibers layer as a somewhat more efficient configuration in the design of filters for respirators.

Development of Active Barrier Multilayer Films Based on Electrospun Antimicrobial Hot-Tack Food Waste Derived Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) and Cellulose Nanocrystal Interlayers.

Active multilayer films based on polyhydroxyalkanoates (PHAs) with and without high barrier coatings of cellulose nanocrystals (CNCs) were herein successfully developed. To this end, an electrospun antimicrobial hot-tack layer made of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) derived from cheese whey, a by-product from the dairy industry, was deposited on a previously manufactured blown film of commercial food contact PHA-based resin. A hybrid combination of oregano essential oil (OEO) and zinc oxide nanoparticles (ZnONPs) were incorporated during the electrospinning process into the PHBV nanofibers at 2.5 and 2.25 wt%, respectively, in order to provide antimicrobial properties. A barrier CNC coating was also applied by casting from an aqueous solution of nanocellulose at 2 wt% using a rod at 1m/min. The whole multilayer structure was thereafter assembled in a pilot roll-to-roll laminating system, where the blown PHA-based film was located as the outer layers while the electrospun antimicrobial hot-tack PHBV layer and the barrier CNC coating were placed as interlayers. The resultant multilayer films, having a final thickness in the 130-150 µm range, were characterized to ascertain their potential in biodegradable food packaging. The multilayers showed contact transparency, interlayer adhesion, improved barrier to water and limonene vapors, and intermediate mechanical performance. Moreover, the films presented high antimicrobial and antioxidant activities in both open and closed systems for up to 15 days. Finally, the food safety of the multilayers was assessed by migration and cytotoxicity tests, demonstrating that the films are safe to use in both alcoholic and acid food simulants and they are also not cytotoxic for Caco-2 cells.

Development of Electrospun Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) Monolayers Containing Eugenol and Their Application in Multilayer Antimicrobial Food Packaging.

In this research, different contents of eugenol in the 2.5-25 wt.% range were first incorporated into ultrathin fibers of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) by electrospinning and then subjected to annealing to obtain antimicrobial monolayers. The most optimal concentration of eugenol in the PHBV monolayer was 15 wt.% since it showed high electrospinnability and thermal stability and also yielded the highest bacterial reduction against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). This eugenol-containing monolayer was then selected to be applied as an interlayer between a structural layer made of a cast-extruded poly(3-hydroxybutyrate) (PHB) sheet and a commercial PHBV film as the food contact layer. The whole system was, thereafter, annealed at 160°C for 10 s to develop a novel multilayer active packaging material. The resultant multilayer showed high hydrophobicity, strong adhesion and mechanical resistance, and improved barrier properties against water vapor and limonene vapors. The antimicrobial activity of the multilayer structure was also evaluated in both open and closed systems for up to 15 days, showing significant reductions (R ≥ 1 and < 3) for the two strains of food-borne bacteria. Higher inhibition values were particularly attained against S. aureus due to the higher activity of eugenol against the cell membrane of Gram positive (G+) bacteria. The multilayer also provided the highest antimicrobial activity for the closed system, which better resembles the actual packaging and it was related to the headspace accumulation of the volatile compounds. Hence, the here-developed multilayer fully based on polyhydroxyalkanoates (PHAs) shows a great deal of potential for antimicrobial packaging applications using biodegradable materials to increase both quality and safety of food products.

The Effect of Static Stretching, Mini-Band Warm-Ups, Medicine-Ball Warm-Ups, and a Light Jogging Warm-Up on Common Athletic Ability Tests.

Proper warm-up is important for facilitating peak athletic performance and reducing injury risk; yet, warm-up procedures vary considerably amongst coaches and athletes. The purpose of this study was to assess the effect of a static stretching, medicine-ball, and mini-band warm-ups relative to a light jogging warm-up only on athletic ability test performance. It was hypothesized that static stretching would negatively affect performance, while medicine-ball and mini-band warm-ups would positively affect performance relative to light jogging only. Twelve female collegiate soccer players (19.3 ± 1.2y, 65.2 ± 7.5kg, 1.67 ± 0.07m) participated in this study. Athletes completed each warm-up protocol and all of the athletic performance tests over four sessions in a semi-randomized, counterbalanced order. An omnibus MANOVA with vertical jump height, medicine ball throw distance, 10m and 20m sprint time, and T-test time as the dependent variables was not significant indicating that warm up did not have an effect on subsequent athletic ability test performance [Wilks' λ = 0.64, F(15,110) = 1.28, p = 0.23, η2 = 0.14]. Static stretching warm-up did not negatively influence athletic potential compared to mini-band and medicine ball warm-ups, though the most optimal warm-up is likely athlete specific.

Electrospun Active Biopapers of Food Waste Derived Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) with Short-Term and Long-Term Antimicrobial Performance.

This research reports about the development by electrospinning of fiber-based films made of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) derived from fermented fruit waste, so-called bio-papers, with enhanced antimicrobial performance. To this end, different combinations of oregano essential oil (OEO) and zinc oxide nanoparticles (ZnONPs) were added to PHBV solutions and electrospun into mats that were, thereafter, converted into homogeneous and continuous films of ~130 µm. The morphology, optical, thermal, mechanical properties, crystallinity, and migration into food simulants of the resultant PHBV-based bio-papers were evaluated and their antimicrobial properties were assessed against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) in both open and closed systems. It was observed that the antimicrobial activity decreased after 15 days due to the release of the volatile compounds, whereas the bio-papers filled with ZnONPs showed high antimicrobial activity for up to 48 days. The electrospun PHBV biopapers containing 2.5 wt% OEO + 2.25 wt% ZnONPs successfully provided the most optimal activity for short and long periods against both bacteria.

Electrospun Antimicrobial Films of Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) Containing Eugenol Essential Oil Encapsulated in Mesoporous Silica Nanoparticles.

The main goal of this study was to develop poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) films with long-term antimicrobial capacity of interest in food packaging applications. To this end, eugenol was first highly efficiently encapsulated at 50 wt.-% in the pores of mesoporous silica nanoparticles by vapor adsorption. The eugenol-containing nanoparticles were then loaded in the 2.5⁻20 wt.-% range into PHBV by electrospinning and the resultant electrospun composite fibers were annealed at 155 °C to produce continuous films. The characterization showed that the PHBV films filled with mesoporous silica nanoparticles containing eugenol present sufficient thermal resistance and enhanced mechanical strength and barrier performance to water vapor and limonene. The antimicrobial activity of the films was also evaluated against foodborne bacteria for 15 days in open vs. closed conditions in order to simulate real packaging conditions. The electrospun PHBV films with loadings above 10 wt.-% of mesoporous silica nanoparticles containing eugenol successfully inhibited the bacterial growth, whereas the active films stored in hermetically closed systems increased their antimicrobial activity after 15 days due to the volatile portion accumulated in the system's headspace and the sustained release capacity of the films. The resultant biopolymer films are, therefore, potential candidates to be applied in active food packaging applications to provide shelf life extension and food safety.

Antimicrobial and Antioxidant Performance of Various Essential Oils and Natural Extracts and Their Incorporation into Biowaste Derived Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) Layers Made from Electrospun Ultrathin Fibers.

In this research, the antibacterial and antioxidant properties of oregano essential oil (OEO), rosemary extract (RE), and green tea extract (GTE) were evaluated. These active substances were encapsulated into ultrathin fibers of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) derived from fruit waste using solution electrospinning, and the resultant electrospun mats were annealed to produce continuous films. The incorporation of the active substances resulted in PHBV films with a relatively high contact transparency, but it also induced a slightly yellow appearance and increased the films opacity. Whereas OEO significantly reduced the onset of thermal degradation of PHBV, both the RE and GTE-containing PHBV films showed a thermal stability profile that was similar to the neat PHBV film. In any case, all the active PHBV films were stable up to approximately 200 °C. The incorporation of the active substances also resulted in a significant decrease in hydrophobicity. The antimicrobial and antioxidant activity of the films were finally evaluated in both open and closed systems for up to 15 days in order to anticipate the real packaging conditions. The results showed that the electrospun OEO-containing PHBV films presented the highest antimicrobial activity against two strains of food-borne bacteria, as well as the most significant antioxidant performance, ascribed to the films high content in carvacrol and thymol. Therefore, the PHBV films developed in this study presented high antimicrobial and antioxidant properties, and they can be applied as active layers to prolong the shelf life of the foods in biopackaging applications.

Antibacterial and Barrier Properties of Gelatin Coated by Electrospun Polycaprolactone Ultrathin Fibers Containing Black Pepper Oleoresin of Interest in Active Food Biopackaging Applications.

The present study evaluated the effect of using electrospun polycaprolactone (PCL) as a barrier coating and black pepper oleoresin (OR) as a natural extract on the morphology, thermal, mechanical, antimicrobial, oxygen, and water vapor barrier properties of solvent cast gelatin (GEL). The antimicrobial activity of the developed multilayer system obtained by the so-called electrospinning coating technique was also evaluated against Staphylococcus aureus strains for 10 days. The results showed that the multilayer system containing PCL and OR increased the thermal resistance, elongated the GEL film, and significantly diminished its permeance to water vapor. Active multilayer systems stored in hermetically closed bottles increased their antimicrobial activity after 10 days by inhibiting the growth of Staphylococcus aureus. This study demonstrates that addition of electrospun PCL ultrathin fibers and OR improved the properties of GEL films, which promoted its potential use in active food packaging applications.

Development of Antimicrobial Biocomposite Films to Preserve the Quality of Bread.

This study focused on the development of gelatin-based films with incorporation of microcrystalline cellulose as reinforcement material. Clove (Syzygium aromaticum), nutmeg (Myristica fragrans), and black pepper (Piper nigrum) oleoresins containing antimicrobial compounds of natural origin were incorporated into the films. The mechanical, thermal, optical, and structural properties, as well as color, seal strength and permeability to water vapor, light, and oil of the films were determined. Adding oleoresins to the gelatin matrix increased the elongation of the material and significantly diminished its permeability to water vapor and oil. Evaluation of the potential use of films containing different oleoresins as bread packaging material was influenced by the film properties. The biocomposite film containing oleoresin from black pepper was the most effective packaging material for maintaining bread's quality characteristics.

EMR-Based Intervention Improves Lead Screening at an Urban Family Medicine Practice.

BACKGROUND AND OBJECTIVES: Elevated blood lead levels have well-described detrimental effects to growth and development in children, yet screening rates remain low. We sought to determine if a reminder within the electronic health record (EHR) could change provider behavior and improve blood lead level (BLL) screening test ordering rates in an urban academic family medicine practice. METHODS: Baseline BLL test ordering rates were calculated for children ages 9-72 months. An update adding reminders to screen was made to the electronic note template used during pediatric well and sick visits at the practice. Data from the 10-week periods both before and after the change was made were compared through a retrospective chart review. RESULTS: A total of 210 children were seen during the pre-intervention period. Forty-eight percent (n=101) had already been screened. Of the 109 eligible for screening, 23 had tests ordered, and 18 of those had tests completed. Eighty-four children were eligible for screening in the post-intervention period. Forty-one of those children had tests ordered, and 15 had tests completed. Provider ordering rates increased from 21% of eligible patients to 49%. Test completion rates only increased from 17% to 18%. CONCLUSIONS: An electronic note-based reminder system significantly improves provider ordering rates of BLL tests. Researchers are currently investigating how the use of point-of-care BLL sample collection can improve test completion rates and therefore increase the frequency of successful screening.

Intraoperative pancreatoscopy: a valuable tool for pancreatic surgeons?

Effective treatment of pancreatic pathology relies on both preoperative and intraoperative decision making. Traditionally, the use of preoperative imaging and endoscopic modalities, in combination with intraoperative findings and pathologic evaluation, has guided the surgeons to perform the correct operative procedure. We hypothesize that the intraoperative use of pancreatoscopy (fiberoptic endoscopy of the pancreatic duct) is a valuable adjunct in selected cases to facilitate the performance of the appropriate definitive surgical treatment. We queried our IRB-approved, prospectively maintained the pancreatic surgery database identifying the uses of intraoperative pancreatoscopy in all pancreatic resections at our institution from 2005-2012. Operative notes, pathology reports, and perioperative outcomes were evaluated. During the study period, 1,016 pancreatic resections were performed at our institution. Twenty-three cases during this period included the use of intraoperative pancreatoscopy. Eighteen (78 %) of these operations were performed for presumed main duct intraductal papillary mucinous neoplasm. In five cases (22 %), the surgical resection was extended secondary to the intraoperative pancreatoscopy findings. Appropriate surgical treatment of the pancreatic lesions can be challenging in the face of preoperative imaging limitations. The selective use of intraoperative fiberoptic endoscopy to evaluate the pancreatic duct appears to help to enable the surgeon to better perform the appropriate resection and optimal treatment.

Wastewater treatment from biodiesel production via a coupled photo-Fenton-aerobic sequential batch reactor (SBR) system.

A coupled system of the photo-Fenton advanced oxidation technique and an aerobic sequential batch reactor (SBR) was used to treat wastewater from biodiesel production using either palm or castor oil. The photo-Fenton reaction and biological process were evaluated individually and were effective at treating the wastewater; nevertheless, each process required longer degradation times for the wastewater pollutants compared with the coupled system. The proposed coupled photo-Fenton/aerobic SBR system obtained a 90% reduction of the chemical oxygen demand (COD) in half of the time required for the biological system individually.