Emulation of Community Water Fluoridation Coverage Across US Counties.

INTRODUCTION: Expansion of community water fluoridation has stalled in the United States, leaving 115 million Americans without fluoridated drinking water. OBJECTIVE: This study used spatial regression methods to assess contributions of supply-side factors (neighboring counties' fluoridation coverage) and demand-side factors (health literacy, education, and population density of the local county) in predicting the extent of fluoridation in US counties. METHODS: For this cross-sectional ecological analysis, data from the 2014 Water Fluoridation Reporting System for all 3,135 US counties were merged with sociodemographic data from the 2014 American Community Survey and county-level estimates of health literacy based on the National Association of Adult Literacy Survey. We employed multilevel geographically weighted autoregressive models to predict fluoridation coverage of each county as a function of fluoridation coverage of neighboring counties and local-county covariates: either health literacy or sociodemographic characteristics. Akaike's Information Criterion was used to distinguish the better model in terms of explanatory power and parsimony. RESULTS: In the best-fit model, an increase from the first to third quartile of neighboring counties' fluoridation coverage was associated with an increase of 27.76 percentage points (95% confidence limits [CI] = 27.71, 27.81) in a local county's fluoridation coverage, while an increase from the first to third quartile of local county's health literacy was associated with an increase of 2.8 percentage points (95% CL = 2.68, 2.89). The results are consistent with a process of emulation, in which counties implement fluoridation based upon their population's health literacy and the extent of fluoridation practiced in neighboring counties. CONCLUSION: These results suggest that demand for community water fluoridation will increase as health literacy increases within a county. Furthermore, when considering expansion of fluoridation, non-fluoridated communities can benefit from precedents from nearby communities that are fluoridated. KNOWLEDGE TRANSFER STATEMENT: Expanded coverage of community water fluoridation has stalled in the United States. The economic theory of diffusion describes how, over time and space, policy enacted in one community can influence public opinion in a neighboring community. This study applies geospatial analysis of county-level data and the theory of policy diffusion to demonstrate that fluoridated counties can promote the implementation of community water fluoridation in their neighboring, non-fluoridated communities.

Technological and safety properties of lactic acid bacteria isolated from Spanish dry-cured sausages.

Technological and safety-related properties were analyzed in lactic acid bacteria isolated from Spanish dry-cured sausages in order to select them as starter cultures. In relation to technological properties, all the strains showed significative nitrate reductase activity; Lactobacillus plantarum, Lactobacillus paracasei and 52% of the Enterococcus faecium strains showed lipolytic activity and only Lactobacillus sakei strains (43%) were able to form biofilms. Related to safety aspects, E. faecium strains were the most resistant to antibiotics, whereas, L. sakei strains were the most sensitive. In relation to virulence factors, in the E. faecium strains analyzed, only the presence of efaA gene was detected. The analysis of biogenic amine production showed that most E. faecium strains and L. sakei Al-142 produced tyramine. In conclusion, L. paracasei Al-128 and L. sakei Al-143 strains possess the best properties to be selected as adequate and safe meat starter cultures.

Characterization of coagulase-negative staphylococci isolated from Spanish dry cured meat products.

Technological and safety-related properties were analyzed in a coagulase-negative staphylococci (CNS) collection isolated from Spanish dry-cured meat products in order to use them as starter cultures. The highest nitrate reductase and proteolytic activity was showed by Staphylococcus carnosus and Staphylococcus equorum. Only a few strains were able to form biofilms and the presence of the ica gene was analyzed on them. In relation to antibiotic resistance, all S. carnosus and most of the S. equorum strains were sensitive to the antibiotics tested and the presence of the blaZ gene in the ß-lactamic resistant strains was studied. Biogenic amines were produced by 25% of the strains analyzed being all the S. carnosus strains tyramine producers. Taking into account the studied properties, two S. equorum strains could be selected as adequate and safe potential starter cultures for the elaboration of meat products.

Production of biogenic amines by lactic acid bacteria and enterobacteria isolated from fresh pork sausages packaged in different atmospheres and kept under refrigeration.

The occurrence of in vitro amino acid activity in bacterial strains associated with fresh pork sausages packaged in different atmospheres and kept in refrigeration was studied. The presence of biogenic amines in decarboxylase broth was confirmed by ion-exchange chromatography and by the presence of the corresponding decarboxylase genes by PCR. From the 93 lactic acid bacteria and 100 enterobacteria strains analysed, the decarboxylase medium underestimates the number of biogenic amine-producer strains. 28% of the lactic acid bacteria produced tyramine and presented the tdc gene. All the tyramine-producer strains were molecularly identified as Carnobacterium divergens. Differences on the relative abundance of C. divergens were observed among the different packaging atmospheres assayed. After 28 days of storage, the presence of argon seems to inhibit C. divergens growth, while packing under vacuum seems to favour it. Among enterobacteria, putrescine was the amine more frequently produced (87%), followed by cadaverine (85%); agmatine and tyramine were only produced by 13 and 1%, respectively, of the strains analysed. Packing under vacuum or in an atmosphere containing nitrogen seems to inhibit the growth of enterobacteria which produce simultaneously putrescine, cadaverine, and agmatine. Contrarily, over-wrapping or packing in an atmosphere containing argon seems to favour the growth of agmatine producer-enterobacteria. The production of putrescine and cadaverine was associated with the presence of the corresponding amino acid decarboxylase genes. The biogenic amine-producer strains were included in a wide range of enterobacterial species, including Kluyvera intermedia, Enterobacter aerogenes, Yersinia kristensenii, Serratia grimesii, Serratia ficaria, Yersinia rodhei, Providencia vermicola and Obesumbacterium proteus.

Integrated multienzyme electrochemical biosensors for monitoring malolactic fermentation in wines.

Integrated amperometric biosensors for the determination of L-malic and L-lactic acids were developed by coimmobilization of the enzymes L-malate dehydrogenase (MDH) and diaphorase (DP), or L-lactate oxidase (LOX) and horseradish peroxidase (HRP), respectively, together with the redox mediator tetrathiafulvalene (TTF), on a 3-mercaptopropionic acid (MPA) self-assembled monolayer (SAM)-modified gold electrode by using a dialysis membrane. The electrochemical oxidation of TTF at +100mV (vs. Ag/AgCl), and the reduction of TTF(+) at -50mV were used for the monitoring of the enzyme reactions involved in L-malic and L-lactic acid determinations, respectively. Experimental variables concerning the biosensors composition and the detection conditions were optimized for each biosensor. Good relative standard deviation values were obtained in both cases for the measurements carried out with the same biosensor, with no need of cleaning or pretreatment of the bioelectrodes surface, and with different biosensors constructed in the same manner. After 7 days of continuous use, the MDH/DP biosensor still exhibited 90% of the original sensitivity, while the LOX/HRP biosensor yielded a 91% of the original response after 5 days. Calibration graphs for L-malic and L-lactic were obtained with linear ranges of 5.2x10(-7) to 2.0x10(-5) and 4.2x10(-7) to 2.0x10(-5)M, respectively. The calculated detection limits were 5.2x10(-7) and 4.2x10(-7)M, respectively. The biosensors exhibited a high selectivity with no significant interferences. They were applied to monitor malolactic fermentation (MLF) induced by inoculation of Lactobacillus plantarum CECT 748(T) into a synthetic wine. Samples collected during MLF were assayed for L-malic and L-lactic acids, and the results obtained with the biosensors exhibited a very good correlation when plotted against those obtained by using commercial enzymatic kits.

Improvement of the fermentation performance of Lactobacillus plantarum by the flavanol catechin is uncoupled from its degradation.

AIMS: To determine the influence of the flavanol catechin on key metabolic traits for the fermentation performance of Lactobacillus plantarum strain RM71 in different media and to evaluate the ability of this strain to catabolize catechin. METHODS AND RESULTS: Growth monitoring and time course of sugar consumption data tracking in chemically defined medium (CDM), revealed that growth of Lact. plantarum strain RM71 upon catechin was characterized by a noticeable shorter lag period, outcome of earlier sugar consumption and lactic acid production courses. Catechin gave rise to higher cell densities compared to controls because of an increased extension of sugar utilization. Fermentation of media relevant for practical fermentation processes with Lact. plantarum strain RM71 showed that catechin sped up malic acid decarboxylation, which besides quicker and extended consumption of several sugars, resulted in faster and higher lactic acid production and growth. Spectrophotometric evaluation of catechin by HPLC-DAD and the lack of catechin concentration-dependent effects showed that the observed stimulations were uncoupled from catechin catabolism by Lact. plantarum. CONCLUSIONS: The flavanol catechin stimulated the growth of Lact. plantarum strain RM71 by promoting quicker sugar consumption, increasing the extension of sugar utilization and stimulating malic acid decarboxylation. These stimulations are uncoupled from catechin catabolism as Lact. plantarum did not catabolize it during fermentation. SIGNIFICANCE AND IMPACT OF THE STUDY: This study, for the first time, examined the influence of the flavanol catechin on the fermentation performance of a Lact. plantarum strain in several media under different fermentation conditions. The information could be relevant to control the production and obtain high-quality food products fermented by this micro-organism.

Biogenic amine production by Gram-positive bacteria isolated from Spanish dry-cured "chorizo" sausage treated with high pressure and kept in chilled storage.

We studied the production of biogenic amines by 200 strains of lactic acid bacteria and staphylococci isolated during chilled storage from samples of Spanish dry-cured "chorizo" sausage treated with high-pressure. The presence of biogenic amines in a decarboxylase synthetic broth was confirmed by ion-exchange chromatography. ß-phenylethylamine was the biogenic amine more frequently produced (22.5%), followed by tyramine (7.5%). In tyramine producer-strains the presence of a tyrosine decarboxylase gene was confirmed by PCR. Among lactic acid bacteria, the production of tyramine was mainly related to the species Lactobacillus curvatus. Most of the L. curvatus strains were also ß-phenylethylamine-producers. In relation to staphylococci, tyramine-production was mainly associated to Staphylococcus carnosus strains. The S. carnosus strains analysed in this study produced ß-phenylethylamine or ß-phenylethylamine and tyramine simultaneously. RAPD-PCR results indicated that the biogenic amine-producer S. carnosus population changes along storage independently of the high-pressure treatment.

Patterns of recurrence in squamous cell carcinoma of the anal canal.

The objective of the study was to identify the patterns of recurrence in patients with squamous cell carcinoma of the anal canal (SCCAC) vs. the size of the primary tumor and its further possible impact on its treatment outcome. We reviewed 78 patients treated between 1975 to 1991. They were classified according to to the AJC/UICC classification. From 1975 to 1985, 16 patients were treated with radical surgery (RS). From 1985 to 1991, 43 patients were treated with radiotherapy (RT) at doses of 45 Gy/4-5 weeks, to the pelvis and a boost of 15-30 Gy to the perineum. Since 1989, in 19 selected patients, 5-FU and mitomycin-C have been added to the RT schedule (C-RT). There were 55 females and 23 males. The overall recurrence rate was 62%. In T1 tumors, no recurrences occurred. The local recurrence (LR) according to treatment approach and T were: radical surgery: T2, 50%; T3, 71%; T4, 100%. Radiation therapy: T2, 25%; T3, 41%; T4, 66%. Chemoradiation therapy: T2, 12%; T3, 40%; T4, 50%. Regional recurrences were in RS: T2, 16%; T3, 28%; T4, 100%. RT: T2, 0%; T3, 16%; T4, 33%. C-RT: T2, 0%; T3, 20%; T4, 25%. Distant recurrences were in RS: T2 and T3, 0%; T4, 66%. In RT: T2, 0%; T3, 8%; T4, 33%. In C-RT: T2, 0%; T3, 8%; T4, 50%. In T1 patients, no recurrences were observed. In T2 tumors the recurrence pattern was local. In T3 tumors it was locoregional and to the groin area. In T4 tumors it was locoregional and distant.(ABSTRACT TRUNCATED AT 250 WORDS)