Pichia yeasts are capable of forming biofilms during vinegar production and causing spoilage in various beverages. In addition, there exists a significant likelihood of encountering yeast contamination which can prevent vinegar production. The present study investigates the detection and characterization of the Pichia manshurica (P. manshurica) biofilm on traditionally produced homemade apple vinegar. The unique characteristics of vinegar were analyzed with a focus on the constituent, known as the \"mother of vinegar\", whose composition is comprised of cellulosic biofilm and acetic acid bacteria, including Gluconobacter oxydans (G. oxydans) Briefly, P. manshurica was isolated from apple vinegar and characterized in terms of the effect of biofilm formation on the surface of the cellulosic film on vinegar production. Microbial identification of vinegar with/without contamination by P. manshurica was analyzed through MALDI-TOF mass spectrometry (MS), and biofilm was characterized by Fourier transform infrared spectroscopy (FT-IR), Scanning electron microscopy (SEM), and crystal violet staining. Accordingly, MS spectrum of isolates was identified as G. oxydans and P. manshurica with a ratio of 2.01 and 1.94, respectively. The FTIR analysis indicated that the peaks within the range of 1150-900 cm-1 revealed a high content of polysaccharide in P. manchuria-contaminated biofilm, which is attributed to the stretching vibration of C-C and C-O bonds. The spectral region from 2921.51 to 2853.71 cm-1 exhibited the characteristic of lipids in bacterial cell walls and membranes. SEM images of bacterial biofilms revealed a three-dimensional network composed of ultrafine fibers with a ribbon-like shape; however, the condensed reticulated structure was observed in contaminated biofilms. The presence of two microbial populations was detected regarding the morphological analysis. Crystal violet staining of contaminated-cellulosic biofilms visualized bacterial and yeast colonization. Concisely, this study emphasizes that the proliferation of Pichia during apple fermentation has the potential to adversely affect the quality of the homemade vinegar, due to its distinct biofilm characteristics.

The safety of homemade weaning foods in low- and middle-income countries is of great concern as rural households have limited access to standardized commercial weaning foods. In the Acholi subregion of Uganda, complementary foods are locally produced. However, there is limited information on the Food safety knowledge (FSK), food safety attitude (FSA), and food hygiene practices (FHP) of the caregivers. This study examined food safety knowledge, attitude, and practices of the caregivers of children 6-23 months of age in Amuru and Nwoya districts, Northern Uganda, between March 2019 and June 2019. A cross-sectional study was conducted involving 180 caregivers. Data were collected using semi-structured questionnaires and focus group discussions and analyzed using descriptive statistics, multivariate binary logistic regression, and thematic content analysis. Caregivers had sufficient FSK (74.1%) and positive FSA (68.1%). However, only 17.6% of them adhered to FHP. Frequency of food safety training (p = .041) and households with children who suffered from foodborne illness (p = .001) significantly predicted FSK. Conversely, both FSK and FSA were significantly predicted by gender roles in decision-making on household income (p = .006) and households with older children (p = .041). A significant positive correlation was observed between FSK and FSA (r = .406, p = .000). However, major barriers to adherence to FHP were inadequate sanitation facilities and caregiver\'s workload. The overall nontranslation of sufficient FSK and positive FSA into proper FHP calls for future intervention to harness the sociodemographic factors that influence FSK and FSA and address the barriers to FHP among caregivers.

For a long time, parallel grafting, physician-modified endografts, and, more recently, in situ fenestration were the only go-to endovascular options for ruptured thoracoabdominal aortic aneurysm, offered mixed results, and depended mainly on the operator\'s and center\'s experience. As custom-made devices have become an established endovascular treatment option for elective thoracoabdominal aortic aneurysm, they are not a viable option in the emergency setting, as endograft production can take up to 4 months. The development of off-the-shelf (OTS) multibranched devices with a standardized configuration has allowed the treatment of ruptured thoracoabdominal aortic aneurysm with emergent branched endovascular procedures. The Zenith t-Branch device (Cook Medical) was the first readily available graft outside the United States to receive the CE mark (in 2012) and is currently the most studied device for those indications. A new device, the E-nside thoracoabdominal branch endoprosthesis OTS multibranched endograft (Artivion), has been made commercially available, and the GORE EXCLUDER thoracoabdominal branch endoprosthesis OTS multibranched endograft (W. L. Gore and Associates) is expected to be released in 2023. Due to the lack of guidelines on ruptured thoracoabdominal aortic aneurysm, this review summarizes the available treatment options (ie, parallel grafts, physician-modified endografts, in situ fenestrations, and OTS multibranched devices), compares the indications and contraindications, and points out the evidence gaps that should be filled in the next decade.

OBJECTIVE: Consumption of sugar sweetened beverages (SSB) is associated with childhood obesity and other negative health conditions. Feeding SSB to infants and young children (IYC) under 2 years may displace consumption of breastmilk and nutrient rich foods critical for optimal growth and development. The World Health Organization (WHO) recommends avoiding added sugar (e.g. SSB) for IYC under 2 years. We sought to describe the variety of homemade and commercial SSB as well as breastmilk and beverages without added sugar fed to IYC aged 4-23 months living in a low-income, populous peri-urban area of Lima, Peru.
METHODS: A cross-sectional survey was conducted with 181 households with IYC aged 4-23 months. A list of common local homemade and commercial beverages was used to investigate what caregivers had fed to the child in the past 24 h.
RESULTS: A total of 93.9% of caregivers reported feeding at least one beverage to their child other than breastmilk in the past 24 h. This included a variety of homemade SSB (73.5%), commercial SSB (18.2%) and homemade beverages without added sugar (70.2%). A high percentage (83.4%) of children were also breastfed.
CONCLUSIONS: Our findings suggest that interventions to address feeding homemade SSB to IYC within households are needed to support WHO recommendations and complement current commercial SSB policy regulations in Peru.

Soybean paste is manufactured through microbial fermentation and may become contaminated with aflatoxins. Herein, we conducted nationwide large-scale monitoring (n = 1436) over three years (2018-2020) to investigate aflatoxin levels according to geographic, demographic, manufacturing, quality factors, and risk characteristics of homemade soybean paste produced through fermentation. The mean level of total aflatoxins was 5.88 μg/kg (range, 0.01-281.92), with the most common contaminating type being the B type. Aflatoxin levels significantly differed according to the region, age of the manufacturer, type of starter used, and the amino-type nitrogen content and pH of the homemade soybean paste (p < 0.05). Aflatoxin levels was significantly higher when starters were manufactured using the traditional method (inoculation with a naturally occurring strain in the surrounding environment). The aflatoxin exposure level estimated through the average intake of homemade soybean paste in all age groups was 0.1012 ng/kg body weight/day. The risk assessment for the genotoxic and carcinogenic potential of aflatoxins using the margin of exposure approach revealed values of 3705-3954 for average intake of homemade soybean paste, indicating public health concern. These results suggest that follow-up studies and safety management strategies are needed to reduce aflatoxin levels in homemade soybean paste.

During the COVID-19 pandemic, a metered-dose inhaler (MDI) with a valved holding chamber (VHC) is a preferred route of bronchodilator delivery. We have developed a new homemade VHC, made of a paper coffee cup, and a drinking water bottle. This study was conducted to compare the bronchodilator response in children with airway hyperresponsiveness after the use of our homemade VHC and that of a standard commercial one.
In a randomized, two-period, two-sequence crossover trial, we recruited 20 children, aged 6-15 years, who had a greater than 12% increase in FEV1 after inhaled salbutamol. They were randomized into Group A and B. Group A used our VHC on the first day and Aerochamber® on the second day. Group B used the same VHCs but in alternate sequence. Spirometries were performed before and after 400 µg of salbutamol, MDI was administered via those VHCs.
Baseline demographic data and spirometric values did not have statistically significant differences between group A and B and between the first and second day (p > .05). After giving salbutamol MDI, both VHCs produced significant increases in FVC, FEV1 , and FEF25-75% (p < .005). The improvement in FEV1 did not significantly differ between our homemade VHC and Aerochamber® (p > .05).
Our homemade VHC is effective for an MDI bronchodilator delivery. Since it is very cheap and easy to make, it may be used as a disposable device to minimize airborne transmission especially when commercial VHC is not available.

BACKGROUND: Following a growing mistrust in a certain number of ingredients used by the cosmetic industry, it has become popular in recent years for consumers to make their own products at home. This trend now touches on all areas of the industry, but is especially found in the hygiene sector, with shampoos and toothpaste, and the care sector, with moisturizers and sunscreen, products.
OBJECTIVE: The objective of this study is to analyze sunscreen recipes found on the Internet and to assess their level of photoprotective efficacy.
METHODS: Fifteen Internet recipes were chosen, and then, the products were made in the laboratory following the protocols described. Using an in vitro method, the following efficacy indicators were determined for the preparations made: the Sun Protection Factor (SPF), the Production Factor in the UVA domain (PF-UVA), and the critical wavelength (λc ).
RESULTS: Three of the 15 recipes studied do not contain any sunscreen and therefore constitute a major risk for users in case of exposure to the sun. The other 12 cannot be considered as sun protection products since all of them have an SPF under 6, the threshold value required in Europe.
CONCLUSIONS: The recipes that we collected on the Internet are very dangerous since some of them have no photoprotective effect whatsoever and most of them do not ensure a sufficient level of photoprotection for the persons using them.

Because specimen removal is often required during video-assisted thoracic surgery, an easily produced, simple-to-use and cost-effective endobag is necessary to avoid wound metastasis. However, commercial endobags are expensive. Here I describe a homemade automatically opening, cost-effective, safe and easily produced endobag for video-assisted thoracic surgery that is suitable for use in low-income locations with limited health budgets.

BACKGROUND: The pomegranate (Punica granatum L.) has gained a reputation as a fruit with many health- promoting properties. It is considered to help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia and inflammatory activities. It has been demonstrated that certain components of pomegranates, such as polyphenols, have potential antioxidant, anti-inflammatory and anticarcinogenic effects.
METHODS: Five commercially available (CA) and three homemade (HM) pomegranate (Puni- ca granatum L.) juices were evaluated for their physicochemical properties including titratable acidity (TA), pH and total soluble solids (TSS), as well as antioxidant properties such as anthocyanin content, ascorbic acid content (AA), antioxidant activity (DPPH), total phenolic compounds (TPC) and ferric reducing antioxidant power (FRAP). Moreover, the concentrations of 18 different elements (Ca, K, Mg, P, S, Na, Cr, Cu, Fe, Mn, Mo, Sr, Zn, Al, Cd, Ni, Pb, Hg) were determined using the ICP-OES method, with prior wet mineralization.
RESULTS: TA was significantly lower (P < 0.05) in homemade than in commercial juices (0.380 and 1.318% citric acid respectively). The TPC and FRAP parameters were about 50% higher in commercial than in homemade juices. Polyphenols were strongly correlated with antioxidant activity measured by FRAP and DPPH tests (r = 0.958 and 0.886 respectively), and a significant correlation for anthocyanins and vitamin C (r = 0.849) was observed. The most common mineral in each tested juice was potassium (132.69–3151.87 mg/dm3) and a high level of magnesium (23.42–123.63 mg/dm3) was found.
CONCLUSIONS: Obtaining juices from whole fruits (peel and arils), as in commercial production, enhanced the content of polyphenol compounds and the antioxidant activity of the juice. However, a better mineral compo- sition was observed in homemade juices.

The use of treated grey water (GW) for home gardens, peri-urban agriculture and landscaping is becoming popular in many water stressed countries such as Oman. This study aims to investigate the treatment efficacy, health and chemical concerns, cost-benefits and maintenance protocol of a GW treatment system as well as the effect of irrigation with GW on crop yield. Therefore, a decentralized homemade GW treatment system was installed in a newly constructed house in Muscat, Oman and studied over a 2-year period. The treated GW was found to be suitable for irrigation as per Omani standards. GW when mixed with kitchen effluent substituted the use of nutrient supplements for plants and did not show any harmful chemical or biological contamination. The capital cost of the system was around US $980, and the annual operating cost was US $78 with annual income and savings from the system being around US $572 indicating a payback period of nearly 2 years. It was found that the system required simple but regular maintenance particularly cleaning of the top layer of the filter. It can be concluded from this study that such a GW system should be technically, economically and environmentally feasible in Oman. Also, wider acceptance by the general public to the idea of GW reuse will help in mitigating the water shortage problem of the country to some extent.