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Shockwaves are mechanical pressure pulses generated in liquids and gases. Based on the principles of acoustics, shockwavescan propagate through fluids such as water. At interfaces of materials with different acoustic impedances, mechanical energy is dissipated, and disintegration of biological tissue can be achieved. Physical properties as well as technical requirements for shockwave generation by electrohydraulic, electromagnetic or piezoelectric energy conversion have been reported in the literature. The use of electrohydraulic shockwaves for food treatment is an emerging food processing technology, where a lack of scientific and technical knowledge has limited further advancements in process and equipment design. In scientific literature, single aspects required for process description are available, e.g., in metallurgy, mining, air purification or particle accelerators, but their combination toward a combined model is required to characterize underlying mechanisms of action. In food, most of the studies have focused on shockwave technology for treatment of meat cuts with the purpose of reducing aging time, softening of tissue and improving its tenderness. Other applications of the shockwave technology could expand to biological inactivation, targeted texture modifications and improving extractive and refining processes in agriculture industries. Total processing costs are estimated in a range of a few Euros per ton of product. Despite being a promising alternative to existing processes used for these purposes, the application of shockwave in the food industry is limited to date to research on pilot-scale prototypes.
PEF is an innovative technology to extend the shelf life of fresh liquid food products, mainly juices, with minor impact on the quality. Many lab scale studies have been published, indicating the great potential of PEF for the juice industry. For industrial realization, the PEF systems have been adapted to the industrial requirements, establishing HACCP and hygienic design concept. Important process parameters have been identified from research and integrated in industrial PEF processes. Juice producers are now able to use PEF for their production lines.
Dadana, Magdalena ; Matysa, Aleksandra ; Kaminska-Dworznicka, Anna ; Lammerskitten, Alica ; Töpfl, Stefan ; Parniakov, Oleksii
This chapter presents the mechanism of the enhancement of freezing by means of ultrasound (US). It has been demonstrated that the effects of US are a rather complex issue. In theory, ultrasound creates cavitation bubbles throughout the volume of the product, which promotes nucleation of the ice and crushes the crystals already present in food. They can also enhance convective heat transfer to the cooling media, thereby accelerating freezing. Moreover, it has been shown that ultrasound reduces the degree of supercooling before nucleation in frozen food. Additionally, numerous experimental studies indicate that ultrasound assisted freezing is a good method to achieve homogenous crystallizations, reduce the deteriorating effect of freezing on food, and thus improve quality after thawing.
Among all nonthermal food processing technologies, high intensity pulsed electric fields (PEF) is one of the most appealing due to its short treatment times and reduced heating effects. Its capability to enhance extraction processes and to inactivate microorganisms at temperatures that do not cause any deleterious effect on flavor, color or nutrient value of foods opens interesting possibilities for the food processing industry.
This new and revised edition of Pulsed Electric Fields Technology for the Food Industry presents the information accumulated on PEF over the last decade by experienced microbiologists, biochemists, food technologists and electrical and food engineers. With insight into current applications of PEF across the food industry, this text offers a comprehensive and up to date resource on PEF application in the food industry from the scientific fundamentals to its use in various food types to environmental and regulatory aspects. For researchers and industry professionals seeking a single source containing all of the relevant and up to date information on PEF in foods, look no further than this essential text.
Joeres, Eike ; Drusch, Stephan ; Töpfl, Stefan ; Juadjur, Andreas ; Bindrich, Ute ; Völker, Thore ; Heinz, Volker ; Terjung, Nino
The influence of moderate electric fields (MEF) on thermally induced gelation and network structures of patatin enriched potato protein (PPI) was investigated. PPI solutions with 9 wt% protein (pH 7) and 25 mM NaCl were heated from 25 to 65 °C via OH (3–24 V/cm) or conventional heating (COV) at various come-up (240 s and 1200 s) and holding times (30 s and 600 s). Self-standing gels were produced but less proteins denatured when heated via OH. Further, SDS-PAGE and GPC measurements revealed more native patatin remaining after OH treatment. Scanning electron microscopy showed OH gels to have more gap-like structures and frayed areas than COV treated gels which resulted in lower water holding capacity. On molecular scale, less hydrophobic interactions were measured within the protein network and FTIR trials showed the MEF to affect beta-sheet structures. OH gels further showed lower rigidity and higher flexibility, thus, gelling functionality was affected via OH.
Shorstkii, Ivan A. ; Stuehmeier-Niehe, Corinna ; Sosnin, Maxim ; Mounassar, Emad Hussein Ali ; Alles, Martina Comiotto ; Siemer, Claudia ; Töpfl, Stefan
The kiwifruit processing industry is focused on product yield maximization and keeping energy costs and waste effluents to a minimum while maintaining high product quality. In our study, pulsed electric field (PEF) pretreatment enhanced kiwifruit processing to facilitate peelability and specific peeling process and enhanced valorization of kiwifruit waste. PEF optimization was applied to obtain the best treatment parameters. A 32 factorial design of response surface methodology was applied to find the effect of time elapsed after PEF treatment and the PEF-specific energy input on specific peeling force and kiwifruit firmness as response criteria. Under the optimized condition, the specific peeling force decreased by 100, and peelability increased by 2 times. The phenolic content and antioxidant capacity of PEF-treated kiwifruit bagasse were 5.1% and 260% richer than the control sample. Overall, the optimized PEF pretreatments incorporated into kiwifruit processing led to decreased energy demand and increased productivity.
Diekmann, Murielle ; Lünenborg, Christina ; Wagner, Lynn ; Speck (geb. Lukas), Melanie ; Bornkessel, Sabine ; Straka, Dorothee
In Deutschland werden jährlich ca. 11 Mio. Tonnen Lebensmittel entlang der Wertschöpfungskette entsorgt.
Die Tafeln verteilen ca. 265 000 Tonnen dieser Lebensmittel
und spielen eine bedeutende Rolle in der Reduzierung von
vermeidbaren Lebensmittelabfällen. Ein Teilziel des Projekts LeMiFair ist es, Einblicke in die Arbeit und die Herausforderungen der Tafeln in Niedersachsen zu gewinnen.
Novel foods by process are a special case in the catalogue of the ten novel food categories according to Article 3 (2) point (a) of the Novel Food Regulation (EU) 2015/2283, since the other nine categories derive their assessment as possible novel foods from their purely substantial properties. In the case of novel foods by process, the problem of dealing with the reference date of 15 May 1997, which is in the end a random reference date, is particularly significant. It would make more sense to have a dynamic reference date that ‘moves along the timeline’ or at least is reset from time to time and is more up-to-date. The characteristic that a process causes ‘significant changes in the composition or structure of the food, affecting its nutritional value, metabolism or level of undesirable substances’ must be understood in such a way that it is only a question of the generation of undesirable substances through the application of the process, but not their reduction, e.g. the reduction of undesirable microorganisms. Finally, the question also arises as to how the assessment of the process technology relates to the assessment of a food in the context of a novel food by composition category. This concerns the exemption for foods that have a history of use as safe foods, which, according to the view taken here, must also be interpreted into the category of novel foods by process.
Kronbauer, Morgana ; Shorstkii, Ivan A. ; Botelho da Silva, Suse ; Töpfl, Stefan ; Lammerskitten, Alica ; Siemer, Claudia
Plant-based proteins are rapidly emerging, while novel technologies are explored to offer more efficient extraction processes. The current study aimed to evaluate the effects of pulsed electric fields (PEFs) and temperature on the extraction of soluble proteins from nettle leaves (Urtica dioica L.) and identify an optimal operational range for the highest yield of soluble proteins. Extractions and kinetic modeling were conducted with whole and ground dried leaves at different temperatures (30–70 °C) and specific energy of PEF (0–30 kJ kg−1) with extraction times of up to 60 min. The influence of temperature and specific energy on the soluble protein extraction yields was investigated and modeled using composite central design and response surface methodology. The experimental results were fitted to Peleg's kinetic model, which satisfactorily described the extraction process (R2 > 0.902), and PEF treated samples resulted in a higher soluble protein yield and shortened processing time. Response surface methodology showed that the linear effect of temperature and quadratic effect of PEF (p < 0.01) were highly significant for protein yield. In the optimized PEF-extraction region (specific energy between 10 and 24 kJ kg−1, and 70–78 °C), soluble protein yield was higher than 60% after 5 minutes of extraction. The achieved results are relevant for developing processes for PEF assisted extraction of soluble proteins from leaves. Understanding the effects of PEFs and process parameters is crucial to obtain high protein yields, while requiring low energy and short processing time.
Joeres, Eike ; Drusch, Stephan ; Töpfl, Stefan ; Juadjur, Andreas ; Psathaki, Olympia Ekaterini ; Heinz, Volker ; Terjung, Nino
Ohmic heating (OH) is an alternative sustainable heating technology that has demonstrated its potential to modify protein structures and aggregates. Furthermore, certain protein aggregates, namely amyloid fibrils (AF), are associated with an enhanced protein functionality, such as gelation. This study evaluates how Ohmic heating (OH) influences the formation of AF structures from ovalbumin source under two electric field strength levels, 8.5 to 10.5 and 24.0–31.0 V/cm, respectively. Hence, AF aggregate formation was assessed over holding times ranging from 30 to 1200 sunder various environmental conditions (3.45 and 67.95 mM NaCl, 80, 85 and 90 °C, pH = 7). AF were formed under all conditions. SDS-PAGE revealed that OH had a higher tendency to preserve native ovalbumin molecules. Furthermore, Congo Red and Thioflavin T stainings indicated that OH reduces the amount of AF structures. This finding was supported by FTIR measurements, which showed OH samples to contain lower amounts of beta-sheets. Field flow fractioning revealed smaller-sized aggregates or aggregate clusters occurred after OH treatment. In contrast, prolonged holding time or higher treatment temperatures increased ThT fluorescence, beta-sheet structures and aggregate as well as cluster sizes. Ionic strength was found to dominate the effects of electric field strength under different environmental conditions.
Olive oil holds significant importance in the European diet and is renowned globally for its sensory attributes and health benefits. The effectiveness of producing olive oil is greatly influenced by factors like the maturity and type of olives used, as well as the milling techniques employed. Generally, mechanical methods can extract approximately 80% of the oil contained in the olives. The rest 20% of the oil remains in the olive waste generated at the end of the process. Additionally, significant amounts of bioactive compounds like polyphenols are also lost in the olive pomace. Traditionally, heat treatment, enzymes, and other chemicals are used for the enhancement of oil extraction; however, this approach may impact the quality of olive oil. Therefore, new technology, such as pulsed electric field (PEF), is of great benefit for nonthermal yield and quality improvements.
Easy and inexpensive methods for measuring ammonia emissions in multi-plot field trials allow the comparison of several treatments with liquid manure application. One approach that might be suitable under these conditions is the dynamic tube method (DTM). Applying the DTM, a mobile chamber system is placed on the soil surface, and the air volume within is exchanged at a constant rate for approx. 90 s. with an automated pump. This procedure is assumed to achieve an equilibrium ammonia concentration within the system. Subsequently, a measurement is performed using an ammonia-sensitive detector tube. Ammonia fluxes are calculated based on an empirical model that also takes into account the background ammonia concentration measured on unfertilized control plots. Between measurements on different plots, the chamber system is flushed with ambient air and cleaned with paper towels to minimize contamination with ammonia. The aim of this study was to determine important prerequisites and boundary conditions for the application of the DTM.
We conducted a laboratory experiment to test if the ammonia concentration remains stable while performing a measurement. Furthermore, we investigated the cleaning procedure and the effect of potential ammonia carryover on cumulated emissions under field conditions following liquid manure application. The laboratory experiment indicated that the premeasurement phase to ensure a constant ammonia concentration is not sufficient. The concentration only stabilized after performing more than 100 pump strokes, with 20 pump strokes (lasting approximately 90 s) being the recommendation.
However, the duration of performing a measurement can vary substantially, and linear conversion accounts for those differences, so a stable concentration is mandatory. Further experiments showed that the cleaning procedure is not sufficient under field conditions. Thirty minutes after performing measurements on high emitting plots, which resulted in an ammonia concentration of approx.
10 ppm in the chamber, we detected a residual concentration of 2 ppm. This contamination may affect measurements on plots with liquid manure application as well as on untreated control plots. In a field experiment with trailing hose application of liquid manure, we subsequently demonstrated that the calculation of cumulative ammonia emissions can vary by a factor of three, depending on the degree of chamber system contamination when measuring control plots. When the ammoni background values were determined by an uncontaminated chamber system that was used to measure only control plots, cumulative ammonia emissions were approximately 9 kg NH3-N ha1.
However, when ammonia background values were determined using the contaminated chamber system that was also used to measure on plots with liquid manure application, the calculation of cumulative ammonia losses indicated approximately 3 kg NH3-N ha1. Based on these results, it can be concluded that a new empirical DTM calibration is needed for multi-plot field experiments with high-emitting treatments.
Daum, Diemo ; Halm, Andreas ; Budke, Christoph ; Reineke, Tobias ; Frerichs, Christian ; Anlauf, Rüdiger
Vorderwülbecke, Gerald ; Spies, Claudia ; von Heymann, Christian ; Kruppa-Scheetz, Jochen ; Fürstenau, Daniel ; Kaufner, Lutz ; Werner, Sven ; Höft, Moritz ; Balzer, Felix
Hintergrund
Die Anämie hat eine hohe Prävalenz bei Patienten vor Hüftgelenkrevisionsoperation und ist mit einer erhöhten Komplikationsrate assoziiert. Die vorliegende Arbeit untersucht erstmals den Zusammenhang von Kosten, realen DRG-Erlösen und Falldeckung der präoperativen Anämie bei elektiven Hüftgelenkrevisionsoperationen.
Methoden
Für alle Patienten, die sich von 2010 bis 2017 an 2 Campi der Charité – Universitätsmedizin Berlin einer Hüftgelenkrevisionsoperation unterzogen, wurden Daten zu Patienten sowie Transfusionen, Kosten und Erlösen gesammelt. Subgruppen- und lineare Regressionsanalysen untersuchten die Falldeckung anämischer und nichtanämischer Patienten.
Ergebnisse
Von 1187 eingeschlossenen Patienten waren 354 (29,8 %) präoperativ anämisch. Insgesamt wurden 565 (47,6 %) Patienten, mit einem deutlichen Überwiegen anämischer Patienten (72,6 % vs. 37,0 %, p < 0,001), transfundiert. Kosten (12.318 € [9027;20.044 €] vs. 8948 € [7501;11.339 €], p < 0,001) und Erlöse (11.788 € [8992;16.298 €] vs. 9611 € [8332;10.719 €], p < 0,001) waren für anämische Patienten höher, die Fallkostendeckung defizitär (−1170 € [−4467;1238 €] vs. 591 € [−1441;2103 €] €, p < 0,001). Bei anämischen Patienten nahm die Falldeckung mit zunehmender Transfusionsrate ab (p ≤ 0,001). Komorbiditäten hatten keinen signifikanten ökonomischen Einfluss.
Schlussfolgerung
Die präoperative Anämie und perioperative Transfusionen bei Hüftgelenkrevisionsoperationen sind mit erhöhten Behandlungskosten und einer finanziellen Unterdeckung für Kostenträger im Gesundheitswesen verbunden. Konzepte zur Behandlung der präoperativen Anämie (z. B. Patient Blood Management) könnten mittelfristig Behandlungskosten senken.
Yürek, Fatima ; Zimmermann, Julian-Dominic ; Weidner, Elisa ; Hauß, Armin ; Dähnert, Enrico ; Hadzidiakos, Daniel ; Kruppa-Scheetz, Jochen ; Kiselev, Joern ; Sichinava, Natia ; Retana Romero, Oscar Andrés ; Hoff, Laerson ; Mörgeli, Rudolf ; Junge, Lennart ; Scholtz, Kathrin ; Piper, Sophie K. ; Grüner, Luzie ; Harborth, Antonia Eva Maria ; Eymold, Lisa ; Gülmez, Tuba ; Falk, Elke ; Balzer, Felix ; Treskatsch, Sascha ; Höft, Moritz ; Schmidt, Dieter ; Landgraf, Franziska ; Marschall, Ursula ; Hölscher, Andreas ; Rafii, Mani ; Spies, Claudia
Introduction Postoperative delirium (POD) is seen in approximately 15% of elderly patients and is related to poorer outcomes. In 2017, the Federal Joint Committee (Gemeinsamer Bundesausschuss) introduced a ‘quality contract’ (QC) as a new instrument to improve healthcare in Germany. One of the four areas for improvement of in-patient care is the ‘Prevention of POD in the care of elderly patients’ (QC-POD), as a means to reduce the risk of developing POD and its complications.
The Institute for Quality Assurance and Transparency in Health Care identified gaps in the in-patient care of elderly patients related to the prevention, screening and treatment of POD, as required by consensus-based and evidence-based delirium guidelines. This paper introduces the QC-POD protocol, which aims to implement these guidelines into the clinical routine. There is an urgent need for well-structured, standardised and interdisciplinary pathways that enable the reliable screening and treatment of POD. Along with effective preventive measures, these concepts have a considerable potential to improve the care of elderly patients.
Methods and analysis The QC-POD study is a non-randomised, pre–post, monocentric, prospective trial with an interventional concept following a baseline control period. The QC-POD trial was initiated on 1 April 2020 between Charité-Universitätsmedizin Berlin and the German health insurance company BARMER and will end on 30 June 2023. Inclusion criteria: patients 70 years of age or older that are scheduled for a surgical procedure requiring anaesthesia and insurance with the QC partner (BARMER). Exclusion criteria included patients with a language barrier, moribund patients and those unwilling or unable to provide informed consent. The QC-POD protocol provides perioperative intervention at least two times per day, with delirium screening and non-pharmacological preventive measures.
Ethics and dissemination This protocol was approved by the ethics committee of the Charité-Universitätsmedizin, Berlin, Germany (EA1/054/20). The results will be published in a peer-reviewed scientific journal and presented at national and international conferences.
A brief questionnaire for measuring alarm fatigue in nurses and physicians in intensive care units
(2023)
Wunderlich, Maximilian Markus ; Amende‑Wolf, Sandro ; Krampe, Henning ; Kruppa-Scheetz, Jochen ; Spies, Claudia ; Weiß, Björn ; Memmert, Belinda ; Balzer, Felix ; Poncette, Akira‑Sebastian
When exposed to hundreds of medical device alarms per day, intensive care unit (ICU) staff can develop “alarm fatigue” (i.e., desensitisation to alarms). However, no standardised way of quantifying alarm fatigue exists. We aimed to develop a brief questionnaire for measuring alarm fatigue in nurses and physicians. After developing a list of initial items based on a literature review, we conducted 15 cognitive interviews with the target group (13 nurses and two physicians) to ensure that the items are face valid and comprehensible. We then asked 32 experts on alarm fatigue to judge whether the items are suited for measuring alarm fatigue. The resulting 27 items were sent to nurses and physicians from 15 ICUs of a large German hospital. We used exploratory factor analysis to further reduce the number of items and to identify scales. A total of 585 submissions from 707 participants could be analysed (of which 14% were physicians and 64% were nurses). The simple structure of a two-factor model was achieved within three rounds. The final questionnaire (called Charité Alarm Fatigue Questionnaire; CAFQa) consists of nine items along two scales (i.e., the “alarm stress scale” and the “alarm coping scale”). The CAFQa is a brief questionnaire that allows clinical alarm researchers to quantify the alarm fatigue of nurses and physicians. It should not take more than five minutes to administer.
Uden, Henning ; Büttner, Franziska ; von Heymann, Christian ; Krämer, Michael ; Kaufner, Lutz ; Vorderwülbecke, Gerald ; Hardt, Sebastian ; Kruppa-Scheetz, Jochen ; Balzer, Felix ; Spies, Claudia
Introduction: Patients undergoing revision total hip surgery (RTHS) have a high prevalence of mild and moderate preoperative anemia, associated with adverse outcomes. The aim of this study was to investigate the association of perioperative allogeneic blood transfusions (ABT) and postoperative complications in preoperatively mild compared to moderate anemic patients undergoing RTHS who did not receive a diagnostic anemia workup and treatment before surgery. Methods: We included 1,765 patients between 2007 and 2019 at a university hospital. Patients were categorized according to their severity of anemia using the WHO criteria of mild, moderate, and severe anemia in the first Hb level of the case. Patients were grouped as having received no ABT, 1–2 units of ABT, or more than 2 units of ABT. Need for intraoperative ABT was assessed in accordance with institutional standards. Primary endpoint was the compound incidence of postoperative complications. Secondary outcomes included major/minor complications and length of hospital and ICU stay. Results: Of the 1,765 patients, 31.0% were anemic of any cause before surgery. Transfusion rates were 81% in anemic patients and 41.2% in nonanemic patients. The adjusted risks for compound postoperative complication were significantly higher in patients with moderate anemia (OR 4.88, 95% CI: 1.54–13.15, p = 0.003) but not for patients with mild anemia (OR 1.93, 95% CI: 0.85–3.94, p < 0.090). Perioperative ABT was associated with significantly higher risks for complications in nonanemic patients and showed an increased risk for complications in all anemic patients. In RTHS, perioperative ABT as a treatment for moderate preoperative anemia of any cause was associated with a negative compound effect on postoperative complications, compared to anemia or ABT alone. Discussion: ABT is associated with adverse outcomes of patients with moderate preoperative anemia before RTHS. For this reason, medical treatment of moderate preoperative anemia may be considered.
Trauzeddel, Ralf Felix ; Rothe, Luisa M. ; Nordine, Michael ; Dehé, Lukas ; Scholtz, Kathrin ; Spies, Claudia ; Hadzidiakos, Daniel ; Winterer, Georg ; Borchers, Friedrich ; Kruppa-Scheetz, Jochen ; Treskatsch, Sascha
Background
Beta-blocker (BB) therapy plays a central role in the treatment of cardiovascular diseases. An increasing number of patients with cardiovascular diseases undergoe noncardiac surgery, where opioids are an integral part of the anesthesiological management. There is evidence to suggest that short-term intravenous BB therapy may influence perioperative opioid requirements due to an assumed cross-talk between G-protein coupled beta-adrenergic and opioid receptors. Whether chronic BB therapy could also have an influence on perioperative opioid requirements is unclear.
Methods
A post hoc analysis of prospectively collected data from a multicenter observational (BioCog) study was performed. Inclusion criteria consisted of elderly patients (≥ 65 years) undergoing elective noncardiac surgery as well as total intravenous general anesthesia without the use of regional anesthesia and duration of anesthesia ≥ 60 min. Two groups were defined: patients with and without BB in their regular preopreative medication. The administered opioids were converted to their respective morphine equivalent doses. Multiple regression analysis was performed using the morphine-index to identify independent predictors.
Results
A total of 747 patients were included in the BioCog study in the study center Berlin. 106 patients fulfilled the inclusion criteria. Of these, 37 were on chronic BB. The latter were preoperatively significantly more likely to have arterial hypertension (94.6%), chronic renal failure (27%) and hyperlipoproteinemia (51.4%) compared to patients without BB. Both groups did not differ in terms of cumulative perioperative morphine equivalent dose (230.9 (BB group) vs. 214.8 mg (Non-BB group)). Predictive factors for increased morphine-index were older age, male sex, longer duration of anesthesia and surgery of the trunk. In a model with logarithmised morphine index, only gender (female) and duration of anesthesia remained predictive factors.
Conclusions
Chronic BB therapy was not associated with a reduced perioperative opioid consumption.
Speck (geb. Lukas), Melanie ; Rohn, Holger ; Scheipe, Marie-Louise ; Ansorge, Jannick ; Liedtke, Christa
Aufgrund seiner starken Umweltauswirkungen gilt der Nahrungsmittelsektor durch Effekte in Produktion, Verarbeitung, Konsum und Entsorgung gemeinhin als ein wichtiges Handlungsfeld, soll eine gesellschaftliche Transformation in Richtung Nachhaltigkeit weiter vorangetrieben werden. Insofern Ernährungsgewohnheiten sowohl ökologische Auswirkungen induzieren als auch gesundheitliche Folgen für die Verbraucher haben, sind Konzepte gefragt, die ökologische mit gesundheitlichen Indikatoren kombinieren; diese sind jedoch bislang rar. Das vorgestellte Instrument des Nutritional Footprint greift diese Problemstellung auf und verbindet jeweils vier Kernindikatoren beider Dimensionen. Mit Hilfe des Konzeptes erhalten Verbraucher einen Überblick zu Umwelt- und Gesundheitswirkungen ihrer Ernährung. Unternehmen können wiederum interne Datensätze verwalten, Benchmarking betreiben und ihre externe Kommunikationsleistung erweitern.
Werkstattbericht zum Projekt NAHGast, Fokus: ‚Leitbild nachhaltiger Gemeinschaftsverpflegung‘
(2016)