SCQM Foundation

The effects of calcium salts, including calcium chloride and calcium carbonate, as well as the phenols gallic acid and ellagic acid, on the activity of two commercial asparaginases were first studied in a model system and then in the production of fried potato chips to mitigate harmful acrylamide. In the model system, calcium carbonate, gallic acid, and ellagic acid enhanced the hydrolysis of asparagine. This promoting effect was also observed for potato chips. When asparaginase was applied together with both calcium salts or phenols in an immersion step before frying, the hydrolysis of asparagine increased compared to using asparaginase alone. These combinations were also effective in acrylamide mitigation in fried chips under moderate conditions for immersion (2.5 min at 45 °C), resulting in an overall decrease of 76−93%. Calcium salts alone prevented acrylamide formation by about 35%, the phenols by 38−43%, and asparaginase treatment alone by 51−62%. The combinations save costs by allowing lower concentrations of asparaginase and additives while minimizing the impact on the sensory properties of the final product. Thus, such combinations of asparaginase with calcium salts or phenols present an attractive option for continued minimization of acrylamide and improvement on food safety.

Abstract This study focused on using natural plant extracts to mitigate the process contaminant acrylamide in fried potato chips, with an emphasis on industrial applicability. Extracts from various plants were tested in a model system for screening purposes. Green tea extract was found to be the most suitable extract for pre-frying treatments, because of its potential to mitigate acrylamide and its good water solubility. For two different green tea extracts, immersion at room temperature (25 °C) for a short time (1.5 min) and at a low concentration (0.1 g L –1 ) resulted in a decrease of acrylamide by 40% under laboratory-scale and by 28% under scaled-up conditions, while higher and lower temperatures were ineffective for acrylamide mitigation. A sensory evaluation with 26 participants confirmed the suitability of the treatment. Interestingly, using catechins present in green tea (epigallocatechin gallate and epicatechin) instead of green tea extract increased acrylamide levels, which may be due to the oxidation of these phenols. Immersion in green tea extract prior to frying is a promising approach to lower acrylamide contents in fried chips.

Antimicrobial resistance is a global health concern, which is partly driven by rising meat consumption, which has led to the intensive farming of livestock that relies on antibiotics. ready-to-eat animal products can carry antibiotic-resistant bacteria, posing risks to humans since they are often consumed without further cooking. While countries such as Switzerland limit antibiotic use in agriculture, contamination of meat with antibiotic-resistant bacteria can still occur during meat processing, and non-antibiotic agents such as heavy metals may contribute to the co-selection of resistance. This study aimed to characterize antibiotic-resistant bacteria in ready-to-eat meat products from various Swiss butcheries. Presumptive resistant bacteria were isolated using selective plating and analyzed phenotypically and genotypically. A total of 53 bacteria-antibiotic resistance combinations were identified, including Enterobacterales resistant to third-generation cephalosporins, vancomycin-resistant Enterococci, and one strain of methicillin-resistant Staphylococcus aureus. Of the 804 products sampled, 177 antibiotic-resistant bacteria were isolated, 148 of which showed multidrug resistance. Notably, these strains remained susceptible to last-resort antibiotics such as carbapenems and colistin. Whole-genome sequencing of 31 selected isolates revealed 164 antibiotic resistance genes spanning 25 classes, confirming resistance to beta-lactams, cephalosporins, and tetracyclines. We also detected genes conferring resistance to metals, suggesting co-selection pressures. Long-read sequencing revealed that the majority of the antibiotic resistance genes were chromosomal, while others were plasmid-encoded, indicating the potential for horizontal gene transfer. This study demonstrates that ready-to-eat meat products are reservoirs of antibiotic and metal resistance genes, as well as antibiotic-resistant bacteria, even at low levels. From a One Health perspective, our results highlight the importance of extending AMR surveillance across the food chain and underscore the need to include non-traditional bacterial indicators.

BackgroundTo investigate a patient-level single imputation approach for patient reported outcomes (PROs) that express similar contents or associated PROs, where a PRO whose value is missing at a particular timepoint is substituted by another PRO whose value is available at the same timepoint.MethodsWe performed a simulation study on registry-based spondyloarthritis data to explore the potential interchangeability between the patient pain (PPA) and fatigue (PFA) assessment scores and relevant Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) individual questions, and between PPA, PFA and patient global assessment (PGA). Performance was assessed per imputation method in terms of relative bias and coverage. Sample size, level of missingness and missing data pattern were included as parameters in the simulations.ResultsAll applied scenarios to interchange PPA with BASDAI question 2 (axial pain), BASDAI question 3 (peripheral joint pain/swelling) or their average failed. Interchangeability between PFA and BASDAI question 1 (fatigue/tiredness) was acceptable for partially (up to 50%) missing data. When interchanging patient assessment scores (PPA, PFA and PGA), we observed inconsistent results in terms of performance. The performance of the applied methods depended on the sample size and the level of missingness, but not heavily on the underlying missing data pattern.ConclusionsInterchanging PFA and the BASDAI fatigue question was justified for partially missing data, while interchangeability between PPA, PFA and PGA, and between PPA and the BASDAI pain questions was not advised. Our findings suggest that registering patient assessment scores and BASDAI questions is recommended.

BackgroundObservational data on composite scores often comes with missing component information. When a complete-case (CC) analysis of composite scores is unbiased, preferable approaches of dealing with missing component information should also be unbiased and provide a more precise estimate. We assessed the performance of several methods compared to CC analysis in estimating the means of common composite scores used in axial spondyloarthritis research.MethodsIndividual mean imputation (IMI), the modified formula method (MF), overall mean imputation (OMI), and multiple imputation of missing component values (MI) were assessed either analytically or by means of simulations from available data collected across Europe. Their performance in estimating the means of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Ankylosing Spondylitis Disease Activity Score based on C-reactive protein (ASDAS-CRP) in cases where component information was set missing completely at random was compared to the CC approach based on bias, variance, and coverage.ResultsLike the MF method, IMI uses a modified formula for observations with missing components resulting in modified composite scores. In the case of an unbiased CC approach, these two methods yielded representative samples of the distribution arising from a mixture of the original and modified composite scores, which, however, could not be considered the same as the distribution of the original score. The IMI and MF method are, thus, intrinsically biased. OMI provided an unbiased mean but displayed a complex dependence structure among observations that, if not accounted for, resulted in severe coverage issues. MI improved precision compared to CC and gave unbiased means and proper coverage as long as the extent of missingness was not too large.ConclusionsMI of missing component values was the only method found successful in retaining CC’s unbiasedness and in providing increased precision for estimating the means of BASDAI, BASFI, and ASDAS-CRP. However, since MI is susceptible to incorrect implementation and its performance may become questionable with increasing missingness, we consider the implementation of an error-free CC approach a valid and valuable option.Trial registrationNot applicable as study uses data from patient registries.

Abstract Background: In comparative effectiveness research, treatment retention - i.e., the time from treatment start to treatment discontinuation - is an important indicator of treatment effectiveness for chronic illnesses. There is no agreement on the event that defines discontinuation. Commonly used are “last dose received”, “decision to discontinue”, or “first dose missed”, as well as mixtures of these in multi-source studies. For drugs administered less frequently than once daily as is the case for many disease-modifying anti-rheumatic drugs (DMARDs) used for the treatment of spondyloarthritis, retention as determined by these events can vary considerably. Our goal was to quantify the impact of the different definitions of discontinuation on conclusions drawn from treatment comparisons and to recommend a standardised definition. Methods: We utilised model-based simulations and real-world data from spondyloarthritis patients treated with tumour necrosis factor (TNF) inhibitors, DMARDs with a wide range of dosing intervals, in Europe. We compared the estimation of the hazard ratio of discontinuation between treatments with varying differences in dosing intervals for the different definitions of discontinuation. To accommodate interval-censored events we used linear transformation models. Results: The simulation revealed increasing differences in the estimated treatment hazard ratio based on time to “last dose received” or “first dose missed” compared to “decision to discontinue” with increasing differences in the dosing interval (up to 55 days). These differences were, however, small and further diminished with mixed events. No bias was observed when the time to “decision to discontinue” was analysed as interval-censored between the times to “last dose received” and “first dose missed” instead of as exactly observed. No clinically meaningful differences in estimated hazard ratios between TNF inhibitors with different dosing intervals (56 versus 7 days) were observed in the real-world data. Conclusions: The impact of the different treatment discontinuation definitions on comparative retention were found to be negligible. Nonetheless, we recommend to define retention as the time from treatment start to the decision to discontinue treatment. Is the timing of the decision unknown, retention can be analysed as interval-censored between the last dose received and the first dose missed using transformation models. Trial registration: Not applicable.

Stable coins can bring stability in volatile crypto markets and during uncertain times. To examine their well-functioning, we assess the degree to which they fulfill the three main functions of a currency: means of payment, unit of account, and store of value. The true benefits of digital money will only materialize when living up to the key principles of peer-to-peer, trustless, and cryptographically secured electronic cash, as proposed in the original bitcoin whitepaper. We conclude that tokenized real-world assets, such as gold, can form an attractive reserve for stable coins. By combining the convenience, portability, and security enabled by blockchain technology with the proven reserve value of gold, it brings the best of both worlds.