Genotypic Variation and Potential Mechanisms of Resistance against Multiple Insect Herbivores in Cranberries.

Plant genotypes often exhibit varying resistance levels to herbivores. However, the impact of this genotypic variation on resistance against multiple herbivores remains poorly understood, especially in crops undergoing recent process of domestication. To address this gap, we studied the magnitude and mechanism of resistance in 12 cranberry (Vaccinium macrocarpon) genotypes to three leaf-chewing herbivores - Sparganothis fruitworm (Sparganothis sulfureana), spotted fireworm (Choristoneura parallela), and spongy moth (Lymantria dispar) - along a domestication gradient (native 'wild' genotypes, 'early hybrid' genotypes, and 'modern hybrid' genotypes). Like cranberries, S. sulfureana and C. parallela are native to the United Sates, while L. dispar is an invasive pest. We measured the survival and growth of larvae on each genotype, as well as variation in plant performance (height and biomass) and leaf defensive chemical traits (C/N ratio, total phenolics, total proanthocyanidins, and flavonols levels) in these genotypes to elucidate potential resistance mechanisms. We found differences in C. parallela and L. dispar larval performance across genotypes, with larvae performing better on the modern hybrid genotypes, while S. sulfureana showed no differences. Morphological and chemical traits varied among genotypes, with total phenolics being the only trait correlated with C. parallela and L. dispar larval performance. Notably, the wild genotypes 'McFarlin' and 'Potter' had higher total phenolics and were more resistant to both herbivores than the modern hybrids 'Demoranville' and 'Mullica Queen.' This research contributes to a comprehensive understanding of the impact of crop domestication on multiple insect herbivores, offering insights for future breeding efforts to enhance host-plant resistance against agricultural pests.

Healthy assemblages of Isidella elongata unintentionally protected from trawling offshore of Asinara Island (northwestern Sardinia, NW Mediterranean Sea).

Deep-sea coral assemblages are marine biodiversity hot spots. Because of their life history traits, deep-sea corals are highly vulnerable to the impacts of human activities such as fishing. The critically endangered "bamboo coral" Isidella elongata is a key structuring species of deep muddy bottoms that is susceptible to habitat destruction, particularly from trawling. A shallow population of this species was recently discovered by a multibeam and ROV survey offshore of the Asinara Island marine protected area (MPA) (northwestern Sardinia, NW Mediterranean Sea). This vulnerable marine assemblage has been found under healthy conditions at depths ranging from 110 to 298 m. Isidella elongata occurs on a muddy seafloor locally characterised by boulders associated with black coral species (Parantipathes larix and Antipathes dichotoma). The lush colonies of I. elongata seem to be related to natural protection from bottom trawling activity; nevertheless, the presence of lost fishing artisanal nets has been observed in the study area. These structuring species are indicators of vulnerable marine ecosystems, and their conservation is essential for preserving marine biodiversity. Therefore, enlarging the perimeter of the Asinara Island MPA into its deeper western waters is suggested to ensure the protection of these valuable and vulnerable marine ecosystems.

Dietary, socioeconomic, and maize handling practices associated with aflatoxin and fumonisin exposure among women tortilla makers in 5 departments in Guatemala.

Previous research has demonstrated human exposure to mycotoxins among Guatemalans, with high levels of mycotoxins being found in blood and urine samples as well as in maize for human consumption. Mishandling of crops such as maize during pre- and post-harvest has been associated with mycotoxin contamination. The overarching goal of this study was to identify risk factors for aflatoxin and fumonisin exposure in Guatemala. A cross-sectional survey of 141 women tortilla makers was conducted in the departments of Guatemala, Sololá, Suchitepéquez, Izabal, and Zacapa in February 2022. Maize and tortilla samples were collected and analyzed for aflatoxin B1 (AFB1) and fumonisin B1, B2, and B3 contamination (FB1, FB2, FB3). Urine samples were collected and analyzed for urinary FB1 (uFB1) contamination. A questionnaire was administered to collect data on sociodemographic characteristics, dietary intake of maize-based foods the week prior to the study, and maize handling practices. Descriptive statistics were used to describe common maize handling practices. A univariable analysis was conducted to identify predictors of low/high AFB1, total fumonisins, and uFB1. Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). During tortilla processing, a reduction in the AFB1 and total fumonisin levels was observed. The presence of AFB1 in maize was associated with department and mean total fumonisin level in maize (OR: 1.705, 95% CI: 1.113-2.613). The department where the tortilleria was located was significantly associated with the presence of fumonisins in tortillas. Increased consumption of Tortrix was significantly associated with the presence of FB1 in urine (OR: 1.652, 95% CI: 1.072-2.546). Results of this study can be used in the development and implementation of supply chain management practices that mitigate mycotoxin production, reduce food waste and economic loss, and promote food security.

Nondestructive and Rapid Screening of Aflatoxin-Contaminated Single Peanut Kernels Using Field-Portable Spectroscopy Instruments (FT-IR and Raman).

A nondestructive and rapid classification approach was developed for identifying aflatoxin-contaminated single peanut kernels using field-portable vibrational spectroscopy instruments (FT-IR and Raman). Single peanut kernels were either spiked with an aflatoxin solution (30 ppb-400 ppb) or hexane (control), and their spectra were collected via Raman and FT-IR. An uHPLC-MS/MS approach was used to verify the spiking accuracy via determining actual aflatoxin content on the surface of randomly selected peanut samples. Supervised classification using soft independent modeling of class analogies (SIMCA) showed better discrimination between aflatoxin-contaminated (30 ppb-400 ppb) and control peanuts with FT-IR compared with Raman, predicting the external validation samples with 100% accuracy. The accuracy, sensitivity, and specificity of SIMCA models generated with the portable FT-IR device outperformed the methods in other destructive studies reported in the literature, using a variety of vibrational spectroscopy benchtop systems. The discriminating power analysis showed that the bands corresponded to the C=C stretching vibrations of the ring structures of aflatoxins were most significant in explaining the variance in the model, which were also reported for Aspergillus-infected brown rice samples. Field-deployable vibrational spectroscopy devices can enable in situ identification of aflatoxin-contaminated peanuts to assure regulatory compliance as well as cost savings in the production of peanut products.

Portable Mid-Infrared Spectroscopy Combined with Chemometrics to Diagnose Fibromyalgia and Other Rheumatologic Syndromes Using Rapid Volumetric Absorptive Microsampling.

The diagnostic criteria for fibromyalgia (FM) have relied heavily on subjective reports of experienced symptoms coupled with examination-based evidence of diffuse tenderness due to the lack of reliable biomarkers. Rheumatic disorders that are common causes of chronic pain such as rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis, and chronic low back pain are frequently found to be comorbid with FM. As a result, this can make the diagnosis of FM more challenging. We aim to develop a reliable classification algorithm using unique spectral profiles of portable FT-MIR that can be used as a real-time point-of-care device for the screening of FM. A novel volumetric absorptive microsampling (VAMS) technique ensured sample volume accuracies and minimized the variation introduced due to hematocrit-based bias. Blood samples from 337 subjects with different disorders (179 FM, 158 non-FM) collected with VAMS were analyzed. A semi-permeable membrane filtration approach was used to extract the blood samples, and spectral data were collected using a portable FT-MIR spectrometer. The OPLS-DA algorithm enabled the classification of the spectra into their corresponding classes with 84% accuracy, 83% sensitivity, and 85% specificity. The OPLS-DA regression plot indicated that spectral regions associated with amide bands and amino acids were responsible for discrimination patterns and can be potentially used as spectral biomarkers to differentiate FM and other rheumatic diseases.

Metabolic Fingerprinting for the Diagnosis of Clinically Similar Long COVID and Fibromyalgia Using a Portable FT-MIR Spectroscopic Combined with Chemometrics.

Post Acute Sequelae of SARS-CoV-2 infection (PASC or Long COVID) is characterized by lingering symptomatology post-initial COVID-19 illness that is often debilitating. It is seen in up to 30-40% of individuals post-infection. Patients with Long COVID (LC) suffer from dysautonomia, malaise, fatigue, and pain, amongst a multitude of other symptoms. Fibromyalgia (FM) is a chronic musculoskeletal pain disorder that often leads to functional disability and severe impairment of quality of life. LC and FM share several clinical features, including pain that often makes them indistinguishable. The aim of this study is to develop a metabolic fingerprinting approach using portable Fourier-transform mid-infrared (FT-MIR) spectroscopic techniques to diagnose clinically similar LC and FM. Blood samples were obtained from LC (n = 50) and FM (n = 50) patients and stored on conventional bloodspot protein saver cards. A semi-permeable membrane filtration approach was used to extract the blood samples, and spectral data were collected using a portable FT-MIR spectrometer. Through the deconvolution analysis of the spectral data, a distinct spectral marker at 1565 cm-1 was identified based on a statistically significant analysis, only present in FM patients. This IR band has been linked to the presence of side chains of glutamate. An OPLS-DA algorithm created using the spectral region 1500 to 1700 cm-1 enabled the classification of the spectra into their corresponding classes (Rcv > 0.96) with 100% accuracy and specificity. This high-throughput approach allows unique metabolic signatures associated with LC and FM to be identified, allowing these conditions to be distinguished and implemented for in-clinic diagnostics, which is crucial to guide future therapeutic approaches.

High yield production of cyanidin-derived pyranoanthocyanins using 4-vinylphenol and 4-vinylguaiacol as cofactors.

Pyranoanthocyanins are anthocyanin-derived pigments with vivid colors and enhanced stability, making them promising food colorants. We evaluated two 4-vinylphenols, decarboxylated p-coumaric (pCA) and ferulic acid (FA), as cofactors for pyranoanthocyanin formation. Cyanidin-3-glycosides from saponified black carrot were incubated with 4-vinylphenol or 4-vinylguaiacol in different anthocyanin-to-cofactor molar ratios (1:1-1:30) to form pyranoanthocyanins. Formation efficiency (45 °C, ≤96 h) was compared to their respective precursors at a 1:30 ratio. Composition changes were monitored using uHPLC-PDA-ESI-MS/MS. Pyranoanthocyanin yields with 4-vinylphenol (13.8-33.4%) were ∼12× higher than with pCA and yields with 4-vinylguaiacol (8.1-31.0%) were ∼6.5× higher than with FA. Molar ratios of 1:5 and 1:10 yielded significantly more pyranoanthocyanins. Pyranoanthocyanin formation with 4-vinylphenols followed first-order kinetics, whereas formation with hydroxycinnamic acids followed zero-order kinetics. Detection of intermediate compounds was consistent with a nucleophilic addition and aromatization formation mechanism. Overall, pyranoanthocyanin formation with 4-vinylphenols was more efficient than with hydroxycinnamic acids.

Screening for pesticide residues in cocoa (Theobroma cacao L.) by portable infrared spectroscopy.

Rapid assessment of pesticide residues ensures cocoa bean quality and marketability. In this study, a portable FTIR instrument equipped with a triple reflection attenuated total reflectance (ATR) accessory was used to screen cocoa beans for pesticide residues. Cocoa beans (n = 75) were obtained from major cocoa growing regions of Peru and were quantified for pesticides by gas chromatography (GC) or liquid chromatography (LC) coupled with mass spectrometry (MS). The FTIR spectra were used to detect the presence of pesticides in cocoa beans or lipid fraction (butter) by using a pattern recognition (Soft Independent Modeling by Class Analogy, SIMCA) algorithm, which produced a significant discrimination for cocoa nibs (free or with pesticides). The variables related to the class grouping were assigned to the aliphatic (3200-2800 cm-1) region with an interclass distance (ICD) of 3.3. Subsequently, the concentration of pesticides in cocoa beans was predicted using a partial least squares regression analysis (PLSR), using an internal validation of the PLRS model, the cross-validation correlation coefficient (Rval = 0.954) and the cross-validation standard error (SECV = 14.9 mg/kg) were obtained. Additionally, an external validation was performed, obtaining the prediction correlation coefficient (Rpre = 0.940) and the standard error of prediction (SEP = 16.0 µg/kg) with high statistical performances, which demonstrates the excellent predictability of the PLSR model in a similar real application. The developed FTIR method presented limits of detection and quantification (LOD = 9.8 µg/kg; LOQ = 23.1 µg/kg) with four optimum factors (PC). Mid-infrared spectroscopy (MIR) offered a viable alternative for field screening of cocoa.

Can legionellosis be considered an occupational risk in the healthcare sector? A systematic review and meta-analysis.

OBJECTIVES: According to current knowledge about legionella transmission, healthcare workers (HCWs) are at an increased risk of exposure. The aim of this research was to systematically review the literature about HCWs' exposure to legionella and establish whether there is an occupational risk. STUDY DESIGN: This was a systematic review and meta-analysis. METHODS: PubMed, Scopus and Web of Science were searched to identify studies regarding the occupational risk of legionellosis for HCWs. Keywords used in the search were 'Legionella pneumophila', 'occupational medicine', 'occupational' and 'risk'. Selected studies were reviewed to assess the quality and meta-analysed. Finally, the nine epidemiological principles of Bradford-Hill criteria were used to assess whether legionellosis could be considered an occupational risk for HCWs. RESULTS: The search strategy retrieved 124 studies, and 10 studies were included in the present review. The overall study quality was low. The pooled odds ratio estimate was 2.45 (95% confidence interval: 1.52-3.96). The assessment using Bradford-Hill criteria showed that only two criteria (plausibility and coherence) were met, which is insufficient to establish an occupational risk. CONCLUSIONS: This systematic review suggests that there is a higher risk of legionella exposure for HCWs, but there is currently no clinical evidence. Further studies with appropriate study design are needed to determine whether legionella infection is an occupational risk for HCWs.

Thermal stability comparison between 10-catechyl-pyranoanthocyanins and anthocyanins derived from pelargonidin, cyanidin, and malvidin.

10-Catechyl-pyranoanthocyanins are pigments derived from nature formed by reacting an anthocyanin with caffeic acid. Here, we compared the thermal stability and formed degradation compounds of different 10-catechyl-pyranoanthocyanins. Pelargonidin-3-glucoside, cyanidin-3-glucoside, malvidin-3-glucoside, anthocyanins differing in the number of substitutions on the B-ring, and their corresponding 10-catechyl-pyranoanthocyanins were heated at 90 °C for 4.5 h at pH 3. Anthocyanin's color faded (ΔELab > 5) after only 0.5 h, and absorbance at λvis-max decreased by > 64 % after 4.5 h, with cyanidin-3-glucoside being the most stable. In contrast, 10-catechyl-pyranoanthocyanins color was heat stable (ΔELab < 5) with absorbance at λvis-max reduced by < 10 % after 4.5 h heating. A phenolic degradation compound formed in all samples, dependent on the parent pigment's B-ring substitutions. All 10-catechyl-pyranoanthocyanins produced the same colored degradation compound (λmax = 478 nm, m/z = 315), suggesting the B-ring was not attached. 10-Catechyl-pyranoanthocyanins displayed excellent thermal stability irrespective of the anthocyanin used for formation.

A novel handheld FT-NIR spectroscopic approach for real-time screening of major cannabinoids content in hemp.

A novel approach for rapid (15s) detection and quantification of predominant cannabinoids in hemp was developed using Fourier-transformed near-infrared spectroscopy (FT-NIR), enabling real-time and field-based applications. Hemp samples (n = 91) were obtained from certified online vendors, the OARDC Weed Lab, and a local Ohio farm. Reference data of major cannabinoids content were determined by uHPLC-MS/MS. Spectral data were collected by a miniaturized, battery-operated FT-NIR instrument, and combined with the reference data to generate partial least squares regression (PLSR) models. uHPLC-MS/MS analysis showed two samples had over 0.36% of Δ9-tetrahydrocannabinol (Δ9-THC), and 64% (32 out of 50) of online-bought hemp samples were not in compliance with their total cannabidiol (CBD) content declaration. PLSR prediction models showed excellent correlation (Rpre = 0.91-0.95) and a low standard error of prediction (SEP = 0.02-0.61%). This method could be used as an alternative to traditional methods for in-situ assessment of hemp quality.

Multicenter retro-prospective observational study on chronic hypoparathyroidism and rhPTH (1-84) treatment.

PURPOSE: The main purpose of this study was to investigate the effects of 12 months of rhPTH (1-84) (Natpar®) treatment in a cohort of patients selected according to the indications of hypoparathyroidism guidelines. The use of recombinant human PTH (1-84) [rhPTH (1-84)] is approved as hormonal replacement therapy in patients with hypoparathyroidism not adequately controlled with conventional therapy. METHODS: It is a multicenter, observational, retro-prospective, open label study. Eleven Italian Endocrinological centers, members of Hypoparathyroidism Working Group of the Italian Society of Endocrinology (HypoparaNET) were involved. Main outcome measures were serum and urinary calcium and phosphate concentration, calcium-phosphate product, renal function, oral calcium and vitamin D doses, and clinical manifestations. RESULTS: Fourteen adult subjects, affected by chronic hypoparathyroidism, were treated with rhPTH (1-84) for 12 months. At 12 months of rhPTH (1-84) treatment, 61.5% of patients discontinued calcium supplement and 69.2% calcitriol. Mean albumin-adjusted total serum calcium levels quickly normalized after initiation of rhPTH (1-84) treatment compared to baseline (p = 0.009), remaining in the normal range until 12 months. Rare hypo-hypercalcemia episodes were reported. Renal function was maintained normal and no renal complications were reported. Serum and urinary phosphate and urinary calcium were maintained in the normal range. Mean phosphatemia levels linearly decreased from 3 months up to 12 months compared to baseline (p = 0.014). No severe adverse events were described. CONCLUSIONS: Biochemical and clinical results confirm the efficacy and safety of rhPTH (1-84) therapy, which represents an important option for hypoparathyroid patients unresponsive to conventional therapy.

Analyzing the Interaction between Anthocyanins and Native or Heat-Treated Whey Proteins Using Infrared Spectroscopy.

The color stability of anthocyanins (ACN) has been shown to be improved by interaction with whey proteins (WP). In this study, we explore the ACN-WP interaction using Fourier transform infrared spectroscopy (IR). ACN from purple corn, grape, and black carrot (50 µM) were evaluated. IR spectra (4000-700 cm-1) were collected for native and preheated (40-80 °C) WP (5 mg/mL) and ACN-WP mixtures at pH 7.4. Soft independent modeling of class analogy was used to analyze the IR data. The WP secondary structure changed after heat treatments and after interaction with ACN. As expected, the WP α-helices decreased, and ß-sheet increased after heat treatment. The intensities of the WP amide I and II bands decreased after ACN addition, revealing a decrease in the WP α-helix content. Higher preheating temperatures (70-80 °C) resulted in a more disordered WP structure that favored stronger WP-ACN interactions related to amide III changes. Addition of ACN stabilized WP structure due to heat denaturation, but different ACN structures had different binding affinities with WP. WP structure had less change after interaction with ACN with simpler structures. These results increase our understanding of ACN-WP interactions, providing a potential strategy to extend anthocyanin color stability by WP addition.

Comparing the thermal stability of 10-carboxy-, 10-methyl-, and 10-catechyl-pyranocyanidin-3-glucosides and their precursor, cyanidin-3-glucoside.

Pyranoanthocyanins are vibrant, naturally derived pigments formed by the reaction of an anthocyanin with a cofactor containing a partially negatively charged carbon. This study compared the thermal stability and degradation products of 10-carboxy-pyranocyanidin-3-glucoside (pyruvic acid cofactor), 10-methyl-pyranocyanidin-3-glucoside (acetone cofactor), and 10-catechyl-pyranocyanidin-3-glucoside (caffeic acid cofactor) with their anthocyanin precursor to evaluate the role of the pyranoanthocyanin C10 substitution on stability. Pyranoanthocyanins exhibited absorbance half-lives ~2.1-8.6 times greater than cyanidin-3-glucoside, with ~15-52% of their original pigment remaining after 12 h of 90 °C heating at pH 3.0. 10-Methyl-pyranocyanidin-3-glucoside was the most stable (p < 0.01) based on UHPLC-PDA analysis, while 10-catechyl-pyranocyanidin-3-glucoside had the most stable color in part due to contribution from a colored degradation compound. Protocatechuic acid formed in all heated samples, which suggested a similar degradation mechanism among pigments. In conclusion, the C10 substitution impacted the extent of pyranoanthocyanin stability and the degradation compounds formed.

Long-term Observation of Thyroid Volume Changes in Hashimoto's Thyroiditis in a Series of Women on or off Levo-Thyroxine Treatment in an Area of Moderate Iodine Sufficiency.

CONTEXT: Large variations in thyroid volume (TV) have been reported in Hashimoto's thyroiditis (HT). The need for long-term levo-thyroxine (L-T4) administration in order to control TV, as well as to normalise thyroid function, has not been well defined. SUBJECTS AND METHODS: Retrospective data on TV in 94 adult women with HT were analysed in an ambulatory setting in Liguria, an area of moderate iodine sufficiency. TV was evaluated by means of ultrasonography (US). Thyroid function, anthropometric data, smoking habits and pharmaceutical drugs were registered at each examination. RESULTS: At the baseline, an atrophic gland was noted in 16% of the women, and goitre in 13%. The women were evaluated 56 and 102 months after the baseline examination. At the time of each examination, 50%, 78% and 83% of women, respectively, were on L-T4 treatment. Baseline TV was not significantly different in women on/off L-T4 treatment. However, in those on L-T4, TV decreased significantly over the period of follow-up, while in those without L-T4 treatment, it did not change. By the end of the study, the percentage of L-T4-treated women with an atrophic gland had increased to 27%, and that of women with goitre had dropped to 6%; in untreated women, only minor changes were noted. There was a significant negative correlation between TV% change and baseline TSH levels in HT women on L-T4 treatment. CONCLUSION: The majority of HT women living in an area of moderate iodine sufficiency have normal TV. Moreover, long-term L-T4 treatment can be used to control TV, as well as to maintain normal thyroid parameters.

Influence of the Anthocyanin and Cofactor Structure on the Formation Efficiency of Naturally Derived Pyranoanthocyanins.

Pyranoanthocyanins are anthocyanin-derived pigments with higher stability to pH and storage. However, their slow formation and scarcity in nature hinder their industrial application. Pyranoanthocyanin formation can be accelerated by selecting anthocyanin substitutions, cofactor concentrations, and temperature. Limited information is available on the impacts of the chemical structure of the cofactor and anthocyanin; therefore, we evaluated their impacts on pyranoanthocyanin formation efficiency under conditions reported as favorable for the reaction. Different cofactors were evaluated including pyruvic acid, acetone, and hydroxycinnamic acids (p-coumaric, caffeic, ferulic, and sinapic acid) by incubating them with anthocyanins in a molar ratio of 1:30 (anthocyanin:cofactor), pH 3.1, and 45 °C. The impact of the anthocyanin aglycone was evaluated by incubating delphinidin, cyanidin, petunidin, or malvidin derivatives with the most efficient cofactor (caffeic acid) under identical conditions. Pigments were identified using UHPLC-PDA and tandem mass spectrometry, and pyranoanthocyanin formation was monitored for up to 72 h. Pyranoanthocyanin yields were the highest with caffeic acid (~17% at 72 h, p < 0.05). When comparing anthocyanins, malvidin-3-O-glycosides yielded twice as many pyranoanthocyanins after 24 h (~20%, p < 0.01) as cyanidin-3-O-glycosides. Petunidin- and delphinidin-3-O-glycosides yielded <2% pyranoanthocyanins. This study demonstrated the importance of anthocyanin and cofactor selection in pyranoanthocyanin production.

Knowledge, attitude, barriers, professional behaviour and possible interventions: a survey on healthcare-associated infections among the healthcare workers of an intensive care unit in a large teaching hospital in Rome.

Methods: A questionnaire of 36 questions was developed and administered to assess socio-occupational characteristics, knowledge of Healthcare-associated infections, attitudes and barriers encountered in compliance with hygiene standards, self-analysis of professional behaviour, and proposals for new interventions. Variables were evaluated by univariate analysis, and multivariable logistic regression models were constructed to identify predictors of adequate knowledge, positive attitude and appropriate professional behaviour. Background: Healthcare-associated infections are the main complications of hospitalization. A bottom-up approach, where the Healthcare workers involved play a key role, can be adopted to limit the Healthcare-associated infections burden. To this end, a survey was conducted in the main intensive care unit of Umberto I Teaching Hospital of Rome, where an active surveillance system has been in place since April 2016. Results: Overall, 79/89 Healthcare workers completed the questionnaire. Multivariate analysis showed that Healthcare workers, who participated in ward meetings to share active surveillance reports, were more likely to have adequate knowledge (aOR=4.21, 95% CI: 1.36-13.07). Only job type seemed to be a predictor of adequate behaviour, since nurses and physicians were more likely to show adequate behaviour than residents in training (aOR=0.21, 95% CI: 0.06-0.74). Direct observation of compliance with standard hygiene precautions and the identification of 'local champions' to manage Healthcare-associated infections' issues were the most requested interventions. Conclusions: Our study suggests that the training of healthcare professionals is a key factor in preventing and containing the spreading of Healthcare-associated infections. Moreover, by encouraging greater Healthcare workers' involvement, we conclude that a bottom-up approach is likely to improve Healthcare-associated infections' prevention and management.

The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study.

BACKGROUND: During the intensive care units' (ICUs) reorganization that was forced by the COVID-19 emergency, attention to traditional infection control measures may have been reduced. Nevertheless, evidence on the effect of the COVID-19 pandemic on healthcare-associated infections (HAIs) is still limited and mixed. In this study, we estimated the pandemic impact on HAI incidence and investigated the HAI type occurring in COVID-19 patients. METHODS: Patients admitted to the main ICU of the Umberto I teaching hospital of Rome from March 1st and April 4th 2020 were compared with patients hospitalized in 2019. We assessed the association of risk factors and time-to-first event through multivariable Fine and Grey's regression models, that consider the competitive risk of death on the development of HAI (Model 1) or device related-HAI (dr-HAI, Model 2) and provide estimates of the sub-distribution hazard ratio (SHR) and its associated confidence interval (CI). A subgroup analysis was performed on the 2020 cohort. RESULTS: Data from 104 patients were retrieved. Overall, 59 HAIs were recorded, 32 of which occurred in the COVID-19 group. Patients admitted in 2020 were found to be positively associated with both HAI and dr-HAI onset (SHR: 2.66, 95% CI 1.31-5.38, and SHR: 10.0, 95% CI 1.84-54.41, respectively). Despite being not confirmed at the multivariable analysis, a greater proportion of dr-HAIs seemed to occur in COVID-19 patients, especially ventilator-associated pneumonia, and catheter-related urinary tract infections. CONCLUSIONS: We observed an increase in the incidence of patients with HAIs, especially dr-HAIs, mainly sustained by COVID-19 patients. A greater susceptibility of these patients to device-related infections was hypothesized, but further studies are needed.

The effect of whey protein concentration and preheating temperature on the color and stability of purple corn, grape and black carrot anthocyanins in the presence of ascorbic acid.

Our objective was to explore the effects of whey protein (WP) concentration and preheating temperature on anthocyanin color expression and stability over time in the presence of ascorbic acid. Anthocyanins from purple corn, grape or black carrot were mixed with native WP or preheated WP (40-80°C) in various concentrations (0-10 mg/mL) in pH 3 buffer containing 0.05% ascorbic acid and stored in the dark at 25 °C for 5 days. WP addition increased anthocyanin absorbance and protected anthocyanin from ascorbic acid-mediated degradation. Increasing WP concentration resulted in lower lightness and higher chroma, hue angle and color stability. The color loss of anthocyanin solutions decreased by 40%-50% when 10 mg/mL WP was added. Native WP showed more color enhancement and protection than thermally-induced WP. Increasing the WP preheating temperature resulted in less absorbance increase and more absorbance loss. Anthocyanin' half-life was improved by addition of WP in a dose dependent manner. Native WP addition (10 mg/mL) extended anthocyanin half-life by about 2 times for purple corn and grape, and 1.31 times for black carrot anthocyanin solutions. Preheating temperature did not significantly affect anthocyanin protection by WP. WP addition might enhance anthocyanin stability in beverages containing ascorbic acid, expanding anthocyanin application in foods.