Effects of Enzyme Replacement Therapy on Cardiac MRI Findings in Fabry Disease: A Systematic Review and Meta-Analysis.

Purpose To perform a systematic review and meta-analysis to assess the effect of enzyme replacement therapy on cardiac MRI parameters in patients with Fabry disease. Materials and Methods A systematic literature search was conducted from January 1, 2000, through January 1, 2024, in PubMed, ClinicalTrials.gov, Embase, and Cochrane Library databases. Study outcomes were changes in the following parameters: (a) left ventricular wall mass (LVM), measured in grams; (b) LVM indexed to body mass index, measured in grams per meters squared; (c) maximum left ventricular wall thickness (MLVWT), measured in millimeters; (d) late gadolinium enhancement (LGE) extent, measured in percentage of LVM; and (e) native T1 mapping, measured in milliseconds. A random-effects meta-analysis of the pooled mean differences between baseline and follow-up parameters was conducted. The study protocol was registered in PROSPERO (CRD42022336223). Results The final analysis included 11 studies of a total of 445 patients with Fabry disease (mean age ± SD, 41 years ± 11; 277 male, 168 female). Between baseline and follow-up cardiac MRI, the following did not change: T1 mapping (mean difference, 6 msec [95% CI: -2, 15]; two studies, 70 patients, I2 = 88%) and LVM indexed (mean difference, -1 g/m2 [95% CI: -6, 3]; four studies, 290 patients, I2 = 81%). The following measures minimally decreased: LVM (mean difference, -18 g [95% CI: -33, -3]; seven studies, 107 patients, I2 = 96%) and MLVWT (mean difference, -1 mm [95% CI: -2, -0.02]; six studies, 151 patients, I2 = 90%). LGE extent increased (mean difference, 1% [95% CI: 1, 1]; three studies, 114 patients, I2 = 85%). Conclusion In patients with Fabry disease, enzyme replacement therapy was associated with stabilization of LVM, MLVWT, and T1 mapping values, whereas LGE extent mildly increased. Keywords: Fabry Disease, Enzyme Replacement Therapy (ERT), Cardiac MRI, Late Gadolinium Enhancement (LGE) Supplemental material is available for this article. © RSNA, 2024.

Carvacrol Microemulsion vs. Nanoemulsion as Novel Pork Minced Meat Active Coatings.

Carvacrol is well documented for its antibacterial and antioxidant effects. However, its high volatility has directed researchers toward nanoencapsulation technology according to bioeconomy and sustainability trends. This study examined and compared free carvacrol (FC), carvacrol microemulsion (MC), carvacrol microemulsion busted with chitosan (MMC), and carvacrol nanoemulsions (NC) as active coatings on extending minced pork meat shelf life at 4 ± 1 °C for 9 days, focusing on microbiological, physiochemical, and sensory characteristics. The research involved pre-characterizing droplet sizes, evaluating antioxidants, and determining antibacterial efficacy. The results demonstrated that NC with a 21 nm droplet size exhibited the highest antioxidant and antibacterial activity. All coatings succeeded in extending the preservation of fresh minced pork meat in comparison to the free carvacrol sample (FC). The NC coating showed the highest extension of minced pork meat preservation and maintained meat freshness for 9 days, with a lower TBARs of 0.736 mg MDA/Kg, and effectively reduced mesophilic, lactic acid, and psychotrophic bacterial counts more significantly by 1.2, 2, and 1.3 log, respectively, as compared to FC. Sensory assessments confirmed the acceptability of NC and MCC coatings. Overall, the carvacrol-based nanoemulsion can be considered a novel antioxidant and antimicrobial active coating due to its demonstrated higher efficacy in all the examined tests performed.

The Development of a Novel Sodium Alginate-Based Edible Active Hydrogel Coating and Its Application on Traditional Greek Spreadable Cheese.

The necessity of reducing the greenhouse effect by decreasing the carbon dioxide fingerprint directed the food packaging technology to use biobased raw materials. Alginates, which are derived from brown algae species, are one of the most promising biobased biopolymers for the development of edible active coatings capable of protecting food from oxidation/bacterial spoilage. In this study, sodium alginate, which was plasticized with glycerol and mixed with a biobased thymol/natural halloysite nanohybrid, was used to develop novel edible active coatings. Nanocomposite coatings were also developed in this project by mixing pure halloysite with sodium alginate/glycerol matrix and were used as reference material for comparison reasons. Instrumental analysis indicated a higher compatibility of a thymol/halloysite nanohybrid with a sodium alginate/glycerol matrix compared to pure halloysite with a sodium alginate/glycerol matrix. Increased compatibility resulted in improved tensile properties, water/oxygen barrier properties, and total antioxidant activity. These edible active coatings were applied to traditional Greek spread cheese and showed a reduction in the mesophilic microbial population over one log10 unit (cfu/g) compared to uncoated cheese. Moreover, the reduction in the mesophilic microbial population increased with the increase in halloysite and thymol content, indicating such sodium alginate/glycerol/thymol/halloysite hydrogels as promising edible active coatings for dairy products.

Thymol@Natural Zeolite Nanohybrids for Chitosan/Polyvinyl-Alcohol-Based Hydrogels Applied as Active Pads.

Currently, food saving, a circular economy, and zero environmental fingerprints are of major interest. Scientific efforts for enhanced food preservation using "green" methods have been intensified. Even though chemicals could achieve such targets effectively, the global trend against the "greenhouse effect" suggests the use of environmentally friendly biobased materials for this purpose. In this study, the promising biopolymer chitosan is incorporated with the promising biodegradable polymer polyvinyl alcohol to produce an improved biopolymeric matrix. This biodegradable biopolymer was further mixed homogeneously with 15% thymol/nano-zeolite nanohybrid material. The properties of the final developed film were improved compared to the relevant values of chitosan/polyvinyl alcohol film. The mechanical properties were enhanced significantly, i.e., there was a 34% increase in Young's modulus and a 4.5% increase in the ultimate tensile strength, while the antioxidant activity increased by 53.4%. The antibacterial activity increased by 134% for Escherichia coli, 87.5% for Staphylococcus aureus, 32% for Listeria monocytogenes, and 9% for Salmonella enterica. The water vapor diffusion coefficient and the oxygen permeability coefficient decreased to -51% and -74%, respectively, and thus, the water vapor and oxygen barrier increased significantly. The active pads were used in strawberries, and the antimicrobial activity evaluation against the mold of fungi was carried out. The visual evaluation shows that the active pads could extend the shelf life duration of strawberries.

Kiwi Fruits Preservation Using Novel Edible Active Coatings Based on Rich Thymol Halloysite Nanostructures and Chitosan/Polyvinyl Alcohol Gels.

The concept of this study is the replacement of previous fossil-based techniques for food packaging and food shelf-life extension, with novel more green processes and materials following the spirit of circular economy and the global trend for environmentally positive fingerprints. A novel adsorption process to produce thymol-halloysite nanohybrids is presented in this work. The high dispersion of this thymol-halloysite nanostructure in chitosan biopolymer is one of the goals of this study. The incorporation of this biodegradable matrix with poly-vinyl-alcohol produced a very promising food-packaging film. Mechanical, water-oxygen barrier, antimicrobial, and antioxidant properties were measured. Transparency levels were also tested using a UV-vis instrument. Moreover, the developed films were tested in-vivo for the preservation and the extension of the shelf-life of kiwi fruits. In all cases, results indicated that the increased fraction of thymol from thyme oil significantly enhances the antimicrobial and antioxidant activity of the prepared chitosan-poly-vinyl- alcohol gel. The use of the halloysite increases the mechanical and water-oxygen barrier properties and leads to a control release process of thymol which extends the preservation and the shelf-life of kiwi fruits. Finally, the results indicated that the halloysite improves the properties of the chitosan/poly-vinyl-alcohol films, and the thymol makes them further advantageous.

Nanocomposite Film Development Based on Chitosan/Polyvinyl Alcohol Using ZnO@Montmorillonite and ZnO@Halloysite Hybrid Nanostructures for Active Food Packaging Applications.

The global turn from the linear to the circular economy imposes changes in common activities such as food packaging. The use of biodegradable materials such as polyvinyl alcohol, natural raw materials such as clays, and food byproducts such as chitosan to develop novel food packaging films attracts the interest of industrial and institutional research centers. In this study, novel hybrid nanostructures were synthesized via the growth of zinc oxide nanorods on the surface of two nanoclays. The obtained nanostructures were incorporated with chitosan/polyvinyl alcohol composite either as nanoreinforcement or as an active agent to develop packaging films. The developed films were characterized via XRD, FTIR, mechanical, water-vapor diffusion, water sorption, and oxygen permeability measurements. Antimicrobial activity measurements were carried out against four different pathogen microorganisms. XRD indicated the formation of an intercalated nanocomposite structure for both types of nanoclays. Furthermore, improved tensile, water/oxygen barrier, and antimicrobial properties were recorded for all films compared to the pure chitosan/polyvinyl alcohol film. Overall, the results indicated that the use of the bio-based developed films led to an extension of food shelf life and could be used as novel active food packaging materials. Among them, the most promising film was the 6% wt. ZnO@halloysite.

Performance of Thyme Oil@Na-Montmorillonite and Thyme Oil@Organo-Modified Montmorillonite Nanostructures on the Development of Melt-Extruded Poly-L-lactic Acid Antioxidant Active Packaging Films.

Today, the use of natural biodegradable materials in the production processes is more and more adopted by industry to achieve cyclic economy targets and to improve environmental and human health indexes. Active packaging is the latest trend for food preservation. In this work, nanostructures were prepared by incorporation of thyme oil with natural natrium-montmorillonite and organo-montmorillonite with two different techniques, direct impregnation and the green evaporation-adsorption process. Such nanostructures were mixed with poly-L-lactic-acid for the first time via an extrusion molding process to develop a new packaging film. Comparisons of morphological, mechanical, and other basic properties for food packaging were carried out via XRD, FTIR, TG, SEM/EDS, oxygen and water vapor permeation, and antimicrobial and antioxidant activity for the first time. Results showed that poly-L-lactic-acid could be modified with clays and essential oils to produce improved active packaging films. The final product exhibits food odor prevention characteristics and shelf-life extension capabilities, and it could be used for active packaging. The films based on OrgMt clay seems to be more promising, while the thyme oil addition improves their behavior as active packaging. The PLLA/3%TO@OrgMt and PLLA/5%TO@OrgMt films were qualified between the tested samples as the most promising materials for this purpose.

Effect of Copper and Titanium-Exchanged Montmorillonite Nanostructures on the Packaging Performance of Chitosan/Poly-Vinyl-Alcohol-Based Active Packaging Nanocomposite Films.

In this study, CuMt and TiMt montmorillonites were produced via an ion-exchange process with Cu+ and Ti4+ ions. These nanostructured materials were characterized with X-ray diffraction (XRD) and fourier transform infrared spectroscopy (FTIR) measurements and added as nanoreinforcements and active agents in chitosan (CS)/poly-vinyl-alcohol (PVOH)-based packaging films. The developed films were characterized by XRD and FTIR measurements. The antimicrobial, tensile, and oxygen/water-barrier measurements for the evaluation of the packaging performance were carried out to the obtained CS/PVOH/CuMt and CS/PVOH/TiMt films. The results of this study indicated that CS/PVOH/CuMt film is a stronger intercalated nanocomposite structure compared to the CS/PVOH/TiMt film. This fact reflected higher tensile strength and water/oxygen-barrier properties. The antibacterial activity of these films was tested against four food pathogenic bacteria: Escherichia coli, Staphylococcus aureus, Salmonella enterica and Listeria monocytogenes. Results showed that in most cases, the antibacterial activity was generated by the CuMt and TiMt nanostructures. Thus, both CS/PVOH/CuMt and CS/PVOH/TiMt films are nanocomposite candidates with very good perspectives for future applications on food edible active packaging.

Antifungal and antiaflatoxigenic assessment of new Cu(II)-pq complexes against Aspergillus parasiticus, in dark conditions and under visible irradiation.

The issue of food contamination by fungi and aflatoxins; constitutes a serious concern not only for human/animal health but also for agriculture and the economy. Aflatoxins are secondary metabolites produced by certain filamentous fungi and contaminate a variety of foodstuffs. In this context, control of fungal growth and aflatoxin contamination appears to be important. The present study aimed to investigate new Cu(I) and Cu(II)-quinoxaline complexes, namely [Cu(2,2´-pq)(NO3)](NO3) (1), [Cu(2,2´-pq)2(NO3)](NO3)·6H2O (2) and [Cu(2,2΄-pq)2](BF4) (3), where 2,2´-pq is 2-(2'-pyridyl quinoxaline), as antifungal agents against Aspergillus parasiticus. All complexes, the ligand and the starting material Cu(NO3)2-3H2O, regardless of the concentration used, caused inhibition of A. parasiticus growth ranged from 8.52 to 33.33%. The fungal growth inhibition was triggered when irradiation in visible (λ > 400 nm) was continuously applied (range 18.36-57.20%). The highest inhibitory activity was exhibited by the complex [Cu(2,2´-pq)2(NO3)](NO3)·6H2O and for this reason, it was selected to be studied for its ability to suppress aflatoxin B1 produced by A. parasiticus. AFB1 production after the irradiation process was found to be suppressed by 25% compared to AFB1 produced in dark conditions.

Echocardiography versus computed tomography and cardiac magnetic resonance for the detection of left heart thrombosis: a systematic review and meta-analysis.

BACKGROUND: Accurate and reproducible diagnostic techniques are essential to detect left-sided cardiac thrombi [either in the left ventricle (LV) or in the left atrial appendage (LAA)] and to guide the onset and duration of antithrombotic treatment while minimizing the risk for thromboembolic and hemorrhagic events. METHODS: We conducted a systematic review and meta-analysis aiming to compare the diagnostic performance of transthoracic echocardiography (TTE) vs. cardiac magnetic resonance (CMR) for the detection of LV thrombi, and transesophageal echocardiography (TEE) vs. computed tomography (CT) for the detection of LAA thrombi. RESULTS: Six studies were included in the first meta-analysis (TTE vs. CMR for LV thrombosis). Pooled sensitivity and specificity values were 62% [95% confidence interval (CI), 37-81%] and 97% (95% CI, 94-99%). The shape of the hierarchical summary receiver operating characteristic (HSROC) curve and the area under the curve (AUC) of 0.96 suggested a high accuracy. Ten studies were included in the second meta-analysis (CT versus TEE for LAA thrombosis). The pooled values of sensitivity and specificity were 97% (95% CI, 77-100%) and 94% (95% CI, 87-98%). The pooled diagnostic odds ratio (DOR) was 500 (95% CI, 52-4810), and the pooled likelihood ratios (LR + and LR-) were 17% (95% CI, 7-40%) and 3% (95% CI, 0-28%). The shape of the HSROC curve and 0.99 AUC suggested a high accuracy of CT vs. TEE. CONCLUSIONS: TTE is a fair alternative to DE-CMR for the identification of LV thrombi, while CT has a good accuracy compared to TEE for the detection of LAA thrombosis. PROSPERO REGISTRATION: CRD42020185842.

Capsaicin, an inhibitor of Ochratoxin A production by Aspergillus section Nigri strains in grapes (Vitis vinifera L.).

Food decay by spoilage fungi leads to significant economic losses and hazards to consumers' health due to the potential of mycotoxin occurrence. Ochratoxin A (OTA) is a mycotoxin known as nephrotoxic and carcinogenic to humans. Natural capsaicin was evaluated for its effectiveness against the growth of five Aspergillus section Nigri strains and accumulation of OTA in inoculated black grapes. Results showed that capsaicin was effective in inhibiting fungal growth and OTA production by new four Aspergillus section Nigri strains (ATHUM 6997, 6998, 6999, 7000) and by Aspergillus carbonarius as well. Moreover, capsaicin addition exhibited maximum inhibition of OTA produced by ATHUM 6997, 6998, 6999, and 7000 in black grapes at 28.9%, 8.6%, 68.4%, and 78.1%, respectively. Inhibition percentage of OTA production by A. carbonarius in grapes treated with capsaicin was estimated at 61.5%. These results suggest that capsaicin influences the OTA biosynthesis pathway of all Aspergillus section Nigri strains and therefore could be used as an effective natural preservative against OTA contamination of vineyards. Risk assessment revealed that when grapes are treated with capsaicin, consumers are less exposed to OTA.

Comparison of Different Extraction Methods for the Determination of the Antioxidant and Antifungal Activity of Cynara scolymus and C. cardunculus Extracts and Infusions.

Extracts and infusions of wild artichoke (Cynara cardunculus L.) and globe artichoke (C. scolymus L.) (heads, bracts and stems) were examined for their total phenolic content (TPC) and their antioxidant activity after performing Classical Extraction (CE) and Ultrasound-Assisted Extraction (UAE). UAE proved to be more effective, since extracts exhibited higher antioxidant activity and TPC values than CE extracts and infusions. Moreover C. cardunculus heads extract using UAE, displayed the maximum TPC values (1.57 mg gallic acid equivalents (GAE) g⁻¹ fresh weight (fw)), the highest DPPH· scavenging activity (IC50; 0.91mg mL⁻¹) and the highest ABTS·+ radical scavenging capacity (2.08 mg Trolox Equivalents (TE) g⁻¹ fw). Moreover, the effect of different concentrations of C. cardunculus head extracts (showing the highest TPC and antioxidant activity) on Aspergillus parasiticus growth was estimated in AFPA medium. The maximum inhibition was found to be 42.1% in comparison with the control.

Αntioxidant activity of Cynara scolymus L. and Cynara cardunculus L. extracts obtained by different extraction techniques.

Extracts of different parts (heads, bracts and stems) of Cynara cardunculus L. (cardoon) and Cynara scolymus L. (globe artichoke), obtained by two different extraction techniques (Ultrasound-Assisted Extraction (UAE) and classical extraction (CE)) were examined and compared for their total phenolic content (TPC) and their antioxidant activity. Moreover, infusions of the plant's parts were also analysed and compared to aforementioned samples. Results showed that cardoon's heads extract (obtained by Ultrasound-Assisted Extraction) displayed the highest TPC values (1.57 mg Gallic Acid Equivalents (GAE) g-1 fresh weight (fw)), the highest DPPH• scavenging activity (IC50; 0.91 mg ml-1) and the highest ABTS•+ radical scavenging capacity (2.08 mg Trolox Equivalents (TE) g-1 fw) compared to infusions and other extracts studied. Moreover, Ultrasound-Assisted Extraction technique proved to be more appropriate and effective for the extraction of antiradical and phenolic compounds.

Aflatoxin B1 in sesame seeds and sesame products from the Greek market.

Aflatoxin B1 (AFB1) is considered as the most potent liver carcinogen for humans. A method for determination in sesame seeds was developed. AFB1 was extracted by methanol-water, cleaned by immunoaffinity columns and determined by high-performance liquid chromatography with fluorescence detection. The recovery factor and the limit of detection (LOD) of AFB1 in sesame seeds were 111.5% and 0.02 ng g(-1), respectively. Thirty samples of sesame products were examined for the presence of AFB1. After analysis, 77.6% of samples were found to be contaminated. Eight samples exceeded the European Union (EU) limit (2 µg AFB1 kg(-1)). In 15 samples, AFB1 was below the EU limit. Seven samples remained below the LOD. The most contaminated (14.49 ng AFB1 g(-1)) sample was unpeeled packaged sesame seeds. In all samples, aflatoxigenic Aspergilli fungi as well as the risk for AFB1 presence in sesame seed was investigated.

Occurrence of aflatoxin B1 and ochratoxin A in dried vine fruits from Greek market.

Twenty-six samples of dried vine fruits from Athens and Thebes (Central Greece) market were simultaneously extracted and cleaned up by immunoaffinity columns and analysed for aflatoxin B1 (AFB1) and ochratoxin A (OTA). A combination of ELISA and HPLC methods was applied for the determination of AFB1. Recovery was 97.6%, RSD 6.46%, while the limit of detection (LOD) and limit of quantification (LOQ) were 0.05 µg kg(-1) and 0.09 µg kg(-1), respectively. OTA concentrations were only estimated by ELISA. Results revealed the presence of AFB1 in 23% of the samples (mean 1.4 µg AFB1 kg(-1)), but none exceeded the EU limit (2 µg AFB1 kg(-1)). However, OTA was detected in 100% of the samples (mean 47.2 µg OTA kg(-1)). Six samples were found to be contaminated at high levels (median 120.6 µg OTA kg(-1)) and 18 exceeded the EU limit (10 µg OTA kg(-1)).

Translation and validation of the Greek chronic liver disease questionnaire.

AIM: To translate into Greek and validate the chronic liver disease questionnaire (CLDQ). METHODS: Two hundred and six consecutive adult patients with the diagnosis of a chronic liver disease from 2 general hospitals in Athens were enrolled in the study from May to September 2008. In order to assess their quality of life (QOL) the CLDQ was applied. The instrument was translated from English, back translated and reviewed in focus groups within the framework of a large multicenter study. The measurements that were performed included: 2 independent sample t tests, one-way analysis of variance, reliability coefficients, explanatory factor analysis using a varimax rotation and the principal components method. RESULTS: One hundred and twenty five (61%) patients were men, half were aged 40-59 years and > 33% were > 60 years old. Among the patients, 48 (23%) were hospitalized and 97 (47%) were cirrhotic according to the Child-Pugh score. The internal consistency of the Greek CLDQ version using Cronbach's alpha coefficient was found to be 0.93. Exploratory factor analysis identified 7 domains accounting for 65% of the variance of CLDQ items and only partially overlapping with those found in the original version. The area under the receiver operating characteristics curve was calculated at 0.813 and the logistic estimate for the threshold score of 167.50 provided a sensitivity of 74.3% and a specificity of 71.6% for the model. CONCLUSION: Our data confirmed the validity of the Greek version of the CLDQ in identifying the QOL among patients with chronic liver disease.