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Linseed oil is rich in unsaturated fatty acids, and its increased consumption could aid in health-promoting nutrition. However, rapid oxidation of linseed oil and concomitant development of bitterness impair consumers' acceptance. Previous research revealed that cyclolinopeptides, a group of cyclic peptides inherent to linseed oil, dominantly contribute to the observed bitterness. In the present study, fresh and stored linseed oil and flaxseed were analyzed for the presence of cyclolinopeptides using preparative high-performance liquid chromatography combined with mass spectrometry- and nuclear magnetic resonance-based identification and quantification. The purified compounds were tested for the activation of all 25 human bitter taste receptors of which only two responded exclusively to methionine-oxidized cyclolinopeptides. Of those, the methionine sulfoxide-containing cyclolinopeptide-4 elicited responses at relevant concentrations. We conclude that this compound is the main determinant of linseed oil's bitterness and propose strategies to reduce the development of bitterness.

Application of the sensomics concept on dried scallops, a Japanese specialty produced from the adductor muscle of scallops, revealed after activity-guided fractionation with subsequent (comparative) taste dilution analyses besides nucleotides, amino acids, organic acids, and inorganic ions, the presence of taste-modulating quaternary ammonium compounds and opines in highly taste-active fractions. In order to recreate the taste of dried scallops, two independent quantitation approaches were applied and compared. The first approach used multiple targeted UHPLC-MS/MS and high-performance ion chromatography methods. Besides already established quantitation methods for basic taste compounds, a new HILIC-UHPLC-MS/MS

A quantitative

ObjectivesTo evaluate a multifaceted intervention on diet, physical activity and health literacy of overweight and obese patients attending primary care.DesignA pragmatic two-arm cluster randomised controlled trial.SettingUrban general practices in lower socioeconomic areas in Sydney and Adelaide.ParticipantsWe aimed to recruit 800 patients in each arm. Baseline assessment was completed by 215 patients (120 intervention and 95 control).InterventionA practice nurse-led preventive health check, a mobile application and telephone coaching.Primary and secondary outcome measuresPrimary outcomes were measured at baseline, 6 and 12 months, and included patient health and eHealth literacy, weight, waist circumference and blood pressure. Secondary outcomes included changes in diet and physical activity, preventive advice and referral, blood lipids, quality of life and costs. Univariate and multivariate analyses of difference-in-differences (DiD) estimates for each outcome were conducted.ResultsAt 6 months, the intervention group, compared with the control group, demonstrated a greater increase in Health Literacy Questionnaire domain 8 score (ability to find good health information; mean DiD 0.22; 95% CI 0.01 to 0.44). There were similar differences for domain 9 score (understanding health information well enough to know what to do) among patients below the median at baseline. Differences were reduced and non-statistically significant at 12 months. There was a small improvement in diet scores at 6 months (DiD 0.98 (0.50 to 1.47); p=0.026) but not at 12 months. There were no differences in eHealth literacy, physical activity scores, body mass index, weight, waist circumference or blood pressure.ConclusionsTargeted recruitment and engagement were challenging in this population. While the intervention was associated with some improvements in health literacy and diet, substantial differences in other outcomes were not observed. More intensive interventions and using codesign strategies to engage the practices earlier may produce a different result. Codesign may also be valuable when targeting lower socioeconomic populations.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN 12617001508369) (http://www.ANZCTR.org.au/ACTRN12617001508369.aspx).Trial protocolThe protocol for this trial has been published (open access;https://bmjopen.bmj.com/content/8/6/e023239).

Background Chronic insomnia is a highly prevalent disorder, with ten to thirty percent of Australian adults reporting chronic difficulties falling asleep and/or staying asleep such that it causes significant daytime impairment. Current Australian general practice guidelines recommend cognitive behavioural therapy for insomnia (CBTi) as first line treatment for insomnia, however research suggests that most general practice consultations for insomnia result in a prescription for hypnotic or sedative medicines. Although the first point of contact for patients experiencing symptoms of insomnia is often general practice, little is known about the current role, experiences and capacity of Australian general practitioners to manage insomnia. This study aimed to address that gap by exploring the attitudes and opinions of general practitioners regarding insomnia management, to inform the development and implementation of new models of best practice insomnia care within general practice. Methods A descriptive, pragmatic qualitative study. Purposive sampling was used to recruit practising Australian general practitioners, varying in age, years of experience and geographic location. Semi-structured interviews were conducted, and data analysed using thematic analysis. Results Twenty-eight general practitioners participated in the study. Three major themes were identified: 1) Responsibility for insomnia care; 2) Complexities in managing insomnia; and 3) Navigating treatment pathways. Whilst general practitioners readily accepted responsibility for the management of insomnia, provision of care was often demanding and difficult within the funding and time constraints of general practice. Patients presenting with comorbid mental health conditions and insomnia, and decision-making regarding long-term use of benzodiazepines presented challenges for general practitioners. Whilst general practitioners confidently provided sleep hygiene education to patients, their knowledge and experience of CBTi, and access and understanding of specialised referral pathways for insomnia was limited. Conclusions General practitioners report that whilst assessing and managing insomnia can be demanding, it is an integral part of general practice. Insomnia presents complexities for general practitioners. Greater clarity about funding options, targeted education about effective insomnia treatments, and referral pathways to specialist services, such as benzodiazepine withdrawal support and psychologists, would benefit insomnia management within general practice.

Sourdough bread is highly enjoyed for its exceptional flavor. In contrast to bread crust, which has been investigated intensively, the knowledge on bread crumb is rather fragmentary. In this study, the taste-active compounds of sourdough bread crumb were identified and quantified. By means of recombination experiments and omission tests, the authentic flavor signature of sourdough rye bread crumb was decoded and recreated with ten key tastants and eleven key odorants. Based on the final taste and aroma recombinants, a fast and sensitive ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method using stable isotope dilution analysis (SIDA) was developed and validated. Due to prior derivatization using 3-nitrophenylhydrazine (3-NPH), key tastants and odorants in bread crumb could be quantified simultaneously in a single UHPLC run. The identified key flavor compounds in combination with the developed UHPLC-MS/MS method could offer the scientific basis for a knowledge-based optimization of the taste and odor of sourdough bread.

Knowledge of both soil quality and contamination has become increasingly important with the growth of urban agriculture in Utah and the United States as whole. Land is also a common limiting factor in urban agriculture, so it is important to maximize yield and net returns. In order to meet these demands, three studies were conducted across key urban agriculture sites along the Wasatch Front: 1) an urban soil survey to assess soil contamination, 2) an urban soil survey to evaluate macronutrient and salinity levels, and 3) a nitrogen fertilizer management trial for dahlia (Dahlia pinnata), a cut flower crop with strong profit potential on urban microfarms. Urban agriculture sites included 31 farms and community gardens that were sampled from the fall of 2020 to spring of 2021 and analyzed for trace elements and hydrocarbon contamination, along with macronutrient levels and general soil quality parameters. Five nitrogen rates (0, 56,112, 168, and 224 kg ha-1) were tested in field trial for the yield and quality of dahlia ‘Café au Lait’ from 2019 to 2021 at the Utah Agricultural Experiment Station Greenville Research Farm. Urban soils were generally below the EPA regional screening limits (RSL) for trace element and hydrocarbon contaminants. However, the mean arsenic concentration was 17 times higher than the EPA RSL of 0.68 ppm, highlighting the need for a localized screening value to inform management practice. The macronutrient levels were above recommended levels across all surveyed sites, with mean soil test phosphorus three times greater than the recommended limit, indicating the need for nutrient management outreach with small, urban farmers and gardeners. Nitrogen management for dahlia was optimized with 168 kg N ha-1 application rates, though virus pressure impacted yields during the first two years of the study. Optimizing management and yield can provide urban farms with a high-value, non-edible food crop option on soils not suited for food production. Routine soil nutrient testing along with site screening for soil contamination is vital to maintaining long-term health and sustainability in urban agriculture.

To gain comprehensive insight into the interactions of key coffee odorants, like the Strecker aldehydes, acetaldehyde, propanal, methylpropanal, 2- and 3-methylbutanal, and methional, and the nonvolatile fraction of coffee, an untargeted metabolomics approach was applied. Ultra performance liquid chromatography (UPLC)-time of flight (TOF)-mass spectrometry (ESI-) profiling followed by statistical data analysis revealed a marker substance for a coffee beverage spiked with acetaldehyde with an accurate mass of 217.0703 [M - H]-. This compound could be identified as a reaction product of quinic acid (QA) and acetaldehyde linked by acetalization at the cis-diol function of QA. Consequently, the acetalization of aldehydes, QA, 5-O-caffeoyl quinic acid (CQA), and quinic acid γ-lactone (QAL) was investigated by means of model reactions, followed by synthesis, isolation, and structure elucidation via UPLC-TOF-MS and 1D and 2D NMR techniques. UHPLC-MS/MSMRM screening and the quantification of aldehyde adducts in coffee beverages revealed the presence of QA/acetaldehyde, -/propanal, -/methylpropanal, and -/methional reaction products and CQA/acetaldehyde, -/propanal, -/methylpropanal, -/2- and 3-methylbutanal, and -/methional and QAL/acetaldehyde adducts for the first time, in concentrations of 12-270 μg/L for QA/aldehydes, 5-225 μg/L for CQA/aldehydes, and 62-173 μg/L for QAL/acetaldehyde. The sensory characterization of the identified compounds showed bitter taste recognition thresholds of 48-297 μmol/L for CQA adducts and 658 μmol/L for QAL/acetaldehyde, while the QA adducts showed no bitter taste (

A holistic ultraperformance liquid chromatography (UPLC)-time of flight (TOF)-mass spectrometry-based approach was used to screen for storage-induced reaction products consisting of the volatile key coffee thiols methanethiol, 2-furfurylthiol, 2-methyl-3-furanthiol, 3-mercapto-3-methylbutanol, and 3-mercapto-2-butanone and low-molecular weight phenolic constituents of coffee beverages including chlorogenic acid, caffeic acid, and their thermal degradation products hydroxyhydroquinone, catechol, and 4-ethylcatechol. Multiple marker compounds could be detected in thiol-enriched coffee brews after UPLC-TOF-MS profiling and statistical data analysis. Subsequently, marker compounds were synthesized and structurally characterized via high-resolution mass spectrometry and 1D- and 2D-NMR experiments. Quantification of these reaction products in fresh and stored coffee beverages was realized in native coffee and after stir bar sorptive extraction with liquid desorption by means of UHPLC-MS/MS. The quantitative data revealed the biggest influence of storage time on the formation of reaction products between hydroxyhydroquinone and methanethiol and 2-furfurylthiol, while other reaction products were only slightly affected by storage and thus most likely formed during the roasting process.

Background: Understanding factors causing variation in family physicians/general practitioners (GPs) screening knowledge, understanding and support of organised population-based colorectal cancer (CRC) programs can direct interventions that maximise the influence of a CRC screening recommendation from a GP. This study aims to assess contextual factors that influence knowledge and quality improvement (QI) practice directed to CRC screening in Australian general practice. Methods: A convenience sample of anonymous general practice staff from all Australian states and territories completed a web-based survey. Multivariate analyses assessed the association between CRC screening knowledge and QI-CRC practice scores and patient, organisational and environmental-level contextual factors. Results: Of 1,013 survey starts, 918 respondents (90.6%) completed the survey. Respondents less likely to recommend FOBT screening had lower knowledge and QI practice scores directed to CRC screening. Controlling for individual and practice characteristics, respondents' rating of the Australian National Bowel Cancer Screening Program (NBCSP) support for preventive care, attending external education, and sufficient practice resources to implement QI practice (generally) were the strongest factors associated with QI practice directed towards CRC screening. Knowledge scores were less amenable to the influence of contextual factors explored. Conclusion: More active engagement of family medicine/general practice to improve screening promotion could be achieved through better QI resourcing without changing the fundamental design of population-based CRC screening programs. Refereed/Peer-reviewed

In Australia, pneumococcal vaccine is provided free to all adults aged ≥65 years and Indigenous people aged 15–65 years, and is subsidized for non-Indigenous adults

Fractionation of high molecular weight (HMW) coffee melanoidins of varying roasting intensity and evaluation of aroma binding activity via nuclear magnetic resonance spectroscopy revealed two fractions 5-10 kDa and 50 kDa with high and selective binding affinity toward key coffee odorants. Quantification of monosaccharides, amino acids and phenolic acids, as well as aliphatic organic acids in hydrolysates of HMW material indicated the importance of aromatic residues in the form of hydroxycinnamic acids for the formation of non-covalent interactions with odorants. Caffeic acid concentrations were up to four times higher in fractions 5-10 kDa and 50 kDa compared to 30-50 kDa and 10-30 kDa fractions. A minimization strategy was developed involving alkaline treatment of the most affine HMW fractions followed by reconstitution at typical coffee concentrations. These reconstituted HMW fractions exhibited up to 25% less aroma binding compared to native fractions of coffee.

The quantitative determination of putative taste active metabolites, the ranking of these compounds in their sensory impact based on dose-overthreshold (DoT) factors, followed by confirmation of their relevance by reconstitution and omission experiments enables the decoding of the non-volatile sensometabolome of certain foods. The identification and quantitation of target taste compounds by liquid chromatography-tandem mass spectrometry (LC-MS/MS), high-performance liquid chromatography-ultraviolet/visible (HPLC-UV/Vis) spectroscopy, or high-performance ion chromatography (HPIC) is often laborious and time-consuming. In this work, we present a novel quantitative 1H NMR approach for reconstituting basic taste recombinants of different foods, including apple juice, balsamic vinegar, golden chanterelles, process flavor, and shrimp. Compound identification using the taste recombinant database, followed by absolute quantitation via quantitative 1H NMR (qHNMR), enables a fast and direct reconstitution of basic taste recombinants. The taste profile analysis of basic taste recombinants was generated via qHNMR in less than 15 min and compared with literature data acquired by LC-MS/MS and/or HPLC-UV/Vis and revealed identical results for all taste qualities. A determination of limit of detection (LoD) values for S/N = 50 of various proton signals with different integrals and multiplicities demonstrated that taste recognition thresholds of all basic tastants are far above those of LoD concentrations under the chosen conditions. Therefore, our experimental setup is able to detect basic taste-active compounds well below their taste recognition thresholds.

Introduction: An understanding of contextual factors that influence whether general practitioners advise their patients to be screened for colorectal cancer (CRC) might guide interventions to increase screening participation from its persistently low rate. We report on the use of a theory-based tool to explore contextual factors that might influence implementation of a novel quality improvement (QI) intervention to increase CRC screening in general practice (CRC-QI). The objective was to identify and incorporate strategies into the intervention that will enable flexible implementation across different practice settings. Study type: A qualitative study to explore contextual facilitators of, and barriers to, the implementation of a novel CRC-QI intervention. Methods: Eighteen staff, from three self-nominated general practices, participated in focus group discussions. The Consolidated Framework for Implementation Research (CFIR), which included constructs relevant to CRC screening in primary care, guided the formative evaluation. Findings were aligned to the CFIR model using a deductive thematic analysis. Results: Contextual facilitators of, and barriers to, the implementation of the CRC-QI intervention were identified in each CFIR domain and CRC-relevant construct. Five consistent themes were identified that potentially influence elements of the CRC-QI intervention: priority setting and incentives, information technology, patient-level barriers, clinical practice, and the National Bowel Cancer Screening Program (NBCSP). Participants proposed that incentive payments and NBCSP policy changes (outer-setting strategies) would facilitate organisational change (inner-setting strategies) and the effective implementation of the CRC-QI intervention. Conclusion: There may be an opportunity to better engage general practice in CRC screening via outer-setting constructs that support existing clinical practice. For example, improvements to the National Cancer Screening Register and Quality Improvement Incentive – Practice Incentives Program (PIP) could be made without altering the NBCSP design.

SUMMARY The important first step in the critical appraisal of a randomised trial is not an evaluation of the statistical analyses. The most important aspect to consider when reviewing a study of a new drug is the appropriateness and quality of the trial design and methods The next most important aspect is the effect size of different treatments and its clinical significance. Rather than reporting statistical significance, studies should report the difference between treatments and its precision Over-reliance on statistical significance and p values may lead to incorrect conclusions. Trial reports about drugs should therefore avoid the term statistical significance and quote p values with caution

Despite the importance of prevention in general practice, electronic clinical record systems used in Australian general practice do not present a comprehensive overview of each patient’s preventive care status to general practitioners or patients. Data relevant to prevention is scattered between different parts of the patient’s record. On-screen reminders to general practitioners are simplistic and easily overlooked, and no reminders are sent automatically to patients. There is no structured means to note a patient’s refusal or ineligibility for a particular preventive activity. Electronic clinical record systems should be enhanced to allow patients to be invited automatically, at appropriate times, to review and respond to comprehensive information and advice about preventive care that is recommended for them. Users of electronic clinical record systems will need to lobby their software vendors to have the proposed enhancements made.

Aside from Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), other less common cannabinoids have recently gained an increasing popularity, mostly due to their promising biological potential. However, time-saving and cost-effective methods for their preparative purification are missing. In this study, trapping multiple dual mode (MDM), a flow-reversal liquid-liquid chromatography (LLC) operating mode, was used for the separation of different minor cannabinoids from a hemp extract. Separation task specific biphasic solvent systems were selected for the purification of the target constituents, as follows: n-hexane/methanol/water 10/6.5/3.5 for cannabielsoin (CBE); n-hexane/methanol/water 10/7/3 for cannabidivarin (CBDV) and cannabigerol (CBG); n-hexane/methanol/water 10/8/2 for cannabinol (CBN) and n-hexane/methanol/water 10/9/1 for cannabichromene (CBC) and cannabicylol (CBL). For each separation task, the concentration of the hemp extract in the feed stream and mobile phase flow rate were selected by shake-flask and stationary phase retention experiments, respectively. For the determination of the trapping MDM operating parameters, the short-cut method was implemented and followed by equilibrium-cell model-based simulations. The trapping MDM allowed the separation of the targeted cannabinoids with purities of 93-99%, yields of 73-95%, solvent consumption 2-4-fold lower and productivities almost double than those obtained using batch separation.

Background The high and increasing demand for obstructive sleep apnea (OSA) care has exceeded the capacity of specialist sleep services prompting consideration of whether general practitioners could have an enhanced role in service delivery. However, little is known about the current involvement, experiences and attitudes of Australian general practitioners towards OSA. The purpose of this study was to provide an in-depth analysis of Australian general practitioners’ experiences and opinions regarding their care of patients with OSA to inform the design and implementation of new general practice models of care. Methods Purposive sampling was used to recruit participants with maximum variation in age, experience and location. Semi-structured interviews were conducted and were analysed using Thematic Analysis. Results Three major themes were identified: (1) General practitioners are important in recognising symptoms of OSA and facilitating a diagnosis by others; (2) Inequities in access to the assessment and management of OSA; and (3) General practitioners currently have a limited role in the management of OSA. Conclusions When consulting with patients with symptoms of OSA, general practitioners see their primary responsibility as providing a referral for diagnosis by others. General practitioners working with patients in areas of greater need, such as rural/remote areas and those of socio-economic disadvantage, demonstrated interest in being more involved in OSA management. Inequities in access to assessment and management are potential drivers for change in future models of care for OSA in general practice.

To map qualitative and quantitative metabolome alterations when Penicillium roqueforti is grown in an environment where l-tyrosine levels are perturbed, the recently established differential off-line LC-NMR (DOLC-NMR) approach was successfully applied in connection with an absolute metabolite quantitation using a quantitative 1H NMR protocol following the ERETIC 2 (Electronic REference To access In vivo Concentrations) methodology. Among the 23 influenced metabolites, amino acid degradation products like 2-(4-hydroxyphenyl)acetic acid and 2-(3,4-dihydroxyphenyl)acetic acid underwent a tremendous upregulation in the amino acid perturbed approach. Moreover, the output of secondary metabolites like andrastin A, eremofortin B, and the tetrapeptide d-Phe-l-Val-d-Val-l-Tyr was affected in the case of the presence or absence of the added aromatic amino acid. Furthermore, the isolated secondary metabolites of P. roqueforti have been quantified for the first time in five divergent Penicillium isolates by means of a validated LC-ECHO-MS/MS method. This technique is used to compensate the effect of co-extracted matrix compounds during the analysis and to utilize quasi-internal standards to quantify all metabolites of interest accurately. This screening outlined the great variety between the different fungi of the same species. The metabolite spectra of wild-type fungi included more toxic intermediates compared to a selected fungi used as a starter culture for blue-mold cheese production. In addition, these secondary metabolites were quantified in commercially available white- and blue-mold cheese samples. The main differences between the analyte profiles of white and blue cheeses were linked to the impact of the used starter culture. Specific metabolites detected from P. roqueforti like andrastin A and B or roquefortine C could not be detected in white cheese. Among the blue cheese samples, different metabolite pattern could be observed regarding various P. roqueforti starter cultures.

Older people might be embarrassed to talk about falling as they worry this may be judged as a loss of their ability to live independently. Ask older patients, at least yearly, if they ever feel unsteady on their feet or if they have fallen Consider whether medicines may be contributing to feelings of unsteadiness or falling. Drugs such as benzodiazepines and selective serotonin reuptake inhibitors, particularly if taken together, are associated with a risk of falling and hip fracture Review the patient’s treatment regimen to see if there are drugs that are no longer required. Psychotropic drugs should usually be tapered gradually so that adverse effects can be minimised Involve a range of health professionals to identify and manage the risk of falls. Help patients stay physically active, independent and socially connected Keywords: antipsychotics, benzodiazepines, deprescribing, opioids, selective serotonin reuptake inhibitors Introduction In Australia, an estimated 30% of people aged over 65 years living in the community and 50% of residents of aged-care facilities fall at least once a year.1,2 The resultant harm is significant. In 2018, the estimated number of Australians aged 50 years and over who were hospitalised for a hip fracture was 28,000.3 An estimated 5% of those who sustain a hip fracture die in hospital, and more than 10% are discharged from hospital to an aged-care facility. More than 50% experience a persistent mobility-related disability one year after their injury.4 Falls typically result from multiple interacting factors. The more factors present, the more likely the person is to fall.1 Medicines are a modifiable risk factor. Adverse effects such as drowsiness, dizziness, blurred vision, confusion or postural hypotension may all contribute to falls.5,6 The association between psychotropic drugs and the increased risk of hip fracture is well recognised.7,8 This is likely to be even greater when psychotropic drugs are used in combination.

Targeted quantitation of 48 basic taste-active compounds in commercial meatlike process flavors, calculation of dose-overthreshold factors, and basic taste re-engineering, followed by activity-guided fractionation, revealed, next to l-glutamate and 5'-ribonucleotides, a series of N-acetylated amino acids and S-((4-amino-2-methylpyrimidin-5-yl)methyl)-l-cysteine as taste-modulating compounds. The N-acetylated amino acids imparted kokumi enhancement with rather high taste thresholds ranging up to 1800 μmol/L ( N-acetylmethionine) in model broth. In comparison, S-((4-amino-2-methylpyrimidin-5-yl)methyl)-l-cysteine, found to be formed by a Maillard-type reaction of thiamine and cysteine, is reported for the first time to exhibit strong kokumi enhancement above a low threshold concentration of 120 μmol/L (model broth). These results will open new avenues toward a knowledge-based optimization of thiamine-containing process flavors.

UPLC–TOF/MS profiling, followed by the recently reported differential off-line LC–NMR (DOLC–NMR) and quantitative 1H NMR spectroscopy (qHNMR), led to the differential qualitative analysis and accurate quantitation of l-tryptophan-induced metabolome alterations of Penicillium roqueforti, which is typically used in making blue-mold cheese. Among the 24 metabolites identified, two tetrapeptides, namely, d-Phe-l-Val-d-Val-l-Tyr and d-Phe-l-Val-d-Val-l-Phe, as well as cis-bis(methylthio)silvatin, are reported for the first time as metabolites of P. roqueforti. Antimicrobial activity tests showed strong effects of the catabolic l-tryptophan metabolites 3-hydroxyanthranilic acid, anthranilic acid, and 3-indolacetic acid against Saccharomyces cerevisiae, with IC50 values between 15.6 and 24.0 μg/mL, while roquefortine C and cis-bis(methylthio)silvatin inhibited the growth of Gram-negative Escherichia coli and Gram-positive Bacillus subtilis with IC50 values between 30.0 and 62.5 μg/mL.