The use of an in vitro fecal fermentation model to uncover the beneficial role of omega-3 and punicic acid in gut microbiota alterations induced by a Western diet.

The influence of gut microbiota in the onset and development of several metabolic diseases has gained attention over the last few years. Diet plays an essential role in gut microbiota modulation. Western diet (WD), characterized by high-sugar and high-fat consumption, alters gut microbiome composition, diversity index, microbial relative levels, and functional pathways. Despite the promising health effects demonstrated by polyunsaturated fatty acids, their impact on gut microbiota is still overlooked. The effect of Fish oil (omega-3 source) and Pomegranate oil (punicic acid source), and a mixture of both oils in gut microbiota modulation were determined by subjecting the oil samples to in vitro fecal fermentations. Cecal samples from rats from two different dietary groups: a control diet (CD) and a high-fat high-sugar diet (WD), were used as fecal inoculum. 16S amplicon metagenomics sequencing showed that Fish oil + Pomegranate oil from the WD group increased α-diversity. This sample can also increase the relative abundance of the Firmicutes and Bacteroidetes phylum as well as Akkermansia and Blautia, which were affected by the WD consumption. All samples were able to increase butyrate and acetate concentration in the WD group. Moreover, tyrosine concentrations, a precursor for dopamine and norepinephrine, increase in the Fish oil + Pomegranate oil WD sample. GABA, an important neurotransmitter, was also increased in WD samples. These results suggest a potential positive impact of these oils' mixture on gut-brain axis modulation. It was demonstrated, for the first time, the great potential of using a mixture of both Fish and Pomegranate oil to restore the gut microbiota changes associated with WD consumption.

The Potential of Acorn Extract Treatment on PUFAs Oxidative Stability: A Case Study on Fish Cooking Wastewater.

Fish byproducts are valuable sources of Ω-3 polyunsaturated fatty acids (PUFAs). Their valorization potentially alleviates pressure on this sector. This study uses a circular economy approach to investigate the oil fraction from sardine cooking wastewater (SCW). Analysis of its fatty acid (FA) profile revealed promising PUFA levels. However, PUFAs are highly susceptible to oxidation, prompting the exploration of effective and natural strategies to replace synthetic antioxidants and mitigate their associated risks and concerns. An antioxidant extract from acorn shells was developed and evaluated for its efficacy in preventing oxidative degradation. The extract exhibited significant levels of total phenolic compounds (TPC: 49.94 and 22.99 mg TAE or GAE/g DW) and antioxidant activities (ABTS: 72.46; ORAC: 59.60; DPPH: 248.24 mg TE/g DW), with tannins comprising a significant portion of phenolics (20.61 mg TAE/g DW). LC-ESI-UHR-QqTOF-MS identified ellagic acid, epicatechin, procyanidin B2 and azelaic acid as the predominant phenolic compounds. The extract demonstrated the ability to significantly reduce the peroxide index and inhibit PUFA oxidation, including linoleic acid (LA), eicosapentaenoic (EPA), and docosahexaenoic acid (DHA). This approach holds promise for developing stable, functional ingredients rich in PUFAs. Future research will focus on refining oil extraction procedures and conducting stability tests towards the development of specific applications.

An Overview on Mushroom Polysaccharides: Health-promoting Properties, Prebiotic and Gut Microbiota Modulation Effects and Structure-function Correlation.

Mushroom polysaccharides are recognized as "biological response modifiers". Besides several bioactivities, a growing interest in their prebiotic potential has been raised due to the gut microbiota modulation potential. This review comprehensively summarizes mushroom polysaccharides' biological properties, structure-function relationship, and underlying mechanisms. It provides a recent overview of the key findings in the field (2018-2024). Key findings and limitations on structure-function correlation are discussed. Although most studies focus on ß-glucans or extracts, α-glucans and chitin have gained interest. Prebiotic capacity has been associated with α-glucans and chitin, while antimicrobial and wound healing potential is attributed to chitin. However, further research is of utmost importance. Human fecal fermentation is the most reported approach to assess prebiotic potential, indicating impacts on intestinal biological, mechanical, chemical and immunological barriers. Gut microbiota dysbiosis has been directly connected with intestinal, cardiovascular, metabolic, and neurological diseases. Concerning gut microbiota modulation, animal experiments have suggested proinflammatory cytokines reduction and redox balance re-establishment. Most literature focused on the anticancer and immunomodulatory potential. However, anti-inflammatory, antimicrobial, antiviral, antidiabetic, hypocholesterolemic, antilipidemic, antioxidant, and neuroprotective properties are discussed. A significant overview of the gaps and research directions in synergistic effects, underlying mechanisms, structure-function correlation, clinical trials and scientific data is also given.

Impact of washing and freezing on nutritional composition, bioactive compounds, antioxidant activity and microstructure of mango peels.

Mango peels are widely produced and highly perishable. Disinfectant washing and freezing are among the most used methods to preserve foods. However, their impact on products' properties is conditioned by the foods' features. This study evaluated for the first time the phytochemical composition, antioxidant activity, and microstructure of mango peels washed with peracetic acid (27 mg/mL for 19 min) and frozen at -20 °C for 30 days. Washing decreased the content of vitamin C (-7%), penta-O-galloyl-ß-d-glucose (-23 %), catechin (-30 %), and lutein (-24 %), but the antioxidant activity was preserved. Freezing changed mango peels' microstructure, increased free phenolic compounds, namely acid gallic (+36 %) and catechin (+51 %), but reduced bound phenolic compounds (-12 % to -87 %), bound phenolic compounds' antioxidant activity (-51 % to -72 %), and violaxanthin (-51 %). Both methods were considered adequate to conserve mango peels since fiber and the main bioactive compounds (free mangiferin, free gallic acid, and ß-carotene) remained unchanged or increased.

Solvent-Induced Raynaud's Phenomenon.

Raynaud's phenomenon (RP) is a vasospastic disorder characterized by an exaggerated vasoconstrictive response to cold or emotional stress. It can be classified as primary (PRP) or secondary (SRP) depending on its association with an underlying condition. We present a case of a young female with severe RP, with trophic changes and abnormal capillaroscopy. After a detailed investigation, a diagnosis of secondary RP due to solvent exposure was made. The patient was treated with calcium channel blocker in low doses, due to hypotension, without improvement of symptoms. Vitamin C and pentoxifylline were added with an unsatisfactory response. Given the progressive worsening of RP and the appearance of trophic lesions, the patient's treatment was reviewed, and continuous intravenous iloprost infusion through an elastomeric pump was started. This resulted in significant symptom improvement and normalization on the capillaroscopic examination.

Primary Cardiac Tumor in the Left Atrium: A Diagnostic Challenge.

An elderly man presented to the emergency department with shortness of breath, peripheral edema, and significant weight loss. Blood tests revealed anemia and elevated inflammatory markers, and chest imaging showed a massive left pleural effusion. During hospitalization, he developed subacute cardiac tamponade, and pericardiocentesis was performed. Further imaging revealed a primary malignant cardiac tumor with extensive infiltration of the cardiac tissue, and biopsy was deemed impossible due to the tumor's location. The most likely diagnosis was angiosarcoma. The cardiac surgery team evaluated the case and considered it inoperable due to the tumor's extensive infiltration. The patient is currently under the regular care of a palliative care team. This case underscores the difficulties of diagnosing primary cardiac tumors, particularly in elderly patients with comorbidities. Despite advances in imaging and surgical techniques, the prognosis for malignant cardiac tumors remains poor.

Spatiotemporal and meteorological relationships in dengue transmission in the Dominican Republic, 2015-2019.

Dengue has broadened its global distribution substantially in the past two decades, and many endemic areas are experiencing increases in incidence. The Dominican Republic recently experienced its two largest outbreaks to date with 16,836 reported cases in 2015 and 20,123 reported cases in 2019. With continued increases in dengue transmission, developing tools to better prepare healthcare systems and mosquito control agencies is of critical importance. Before such tools can be developed, however, we must first better understand potential drivers of dengue transmission. To that end, we focus in this paper on determining relationships between climate variables and dengue transmission with an emphasis on eight provinces and the capital city of the Dominican Republic in the period 2015-2019. We present summary statistics for dengue cases, temperature, precipitation, and relative humidity in this period, and we conduct an analysis of correlated lags between climate variables and dengue cases as well as correlated lags among dengue cases in each of the nine locations. We find that the southwestern province of Barahona had the largest dengue incidence in both 2015 and 2019. Among all climate variables considered, lags between relative humidity variables and dengue cases were the most frequently correlated. We found that most locations had significant correlations with cases in other locations at lags of zero weeks. These results can be used to improve predictive models of dengue transmission in the country.

Impact of LAB from Serpa PDO Cheese in Cheese Models: Towards the Development of an Autochthonous Starter Culture.

Serpa is a protected designation of origin (PDO) cheese produced with raw ewes' milk and coagulated with Cynara cardunculus. Legislation does not allow for milk pasteurization and starter culture inoculation. Although natural Serpa's rich microbiota allows for the development of a unique organoleptic profile, it also suggests high heterogeneity. This raises issues in the final sensory and safety properties, leading to several losses in the sector. A possible solution to overcoming these issues is the development of an autochthonous starter culture. In the present work, some Serpa cheese Lactic acid bacteria (LAB)-isolated microorganisms, previously selected based on their safety, technological and protective performance, were tested in laboratory-scale cheeses. Their acidification, proteolysis (protein and peptide profile, nitrogen fractions, free amino acids (FAA)), and volatiles generation (volatile fatty acids (VFA) and esters) potential was investigated. Significant differences were found in all parameters analyzed, showing a considerable strain effect. Successive statistical analyses were performed to compare cheese models and Serpa PDO cheese. The strains L. plantarum PL1 and PL2 and the PL1 and L. paracasei PC mix were selected as the most promising, resulting in a closer lipolytic and proteolytic profile of Serpa PDO cheese. In future work, these inocula will be produced at a pilot scale and tested at the cheese level to validate their application.

The Health-promoting Potential of Edible Mushroom Proteins.

Edible mushrooms have been classified as "next-generation food" due to their high nutritional value coupled with their biological and functional potential. The most extensively studied and reported mushroom macromolecules are polysaccharides. However, macrofungi proteins and peptides are also a representative and significant bioactive group. Several factors such as species, substrate composition and harvest time significantly impact the mushroom protein content, typically ranging between 19 and 35% on a dry weight basis. Proteins work based on their shape and structure. Numerous extraction methods, including chemical and non-conventional, and their implications on protein yield and stability will be discussed. Beyond their biological potential, a great advantage of mushroom proteins is their uniqueness, as they often differ from animal, vegetable, and microbial proteins. According to recently published reports, the most relevant mushroom bioactive proteins and peptides include lectins, fungal immunomodulatory proteins, ubiquitin-like proteins, and proteins possessing enzymatic activity such as ribonucleases laccases, and other enzymes and ergothioneine. These are reported as antioxidant, antiviral, antifungal, antibacterial, antihypertensive, immunomodulatory, antitumour, antihypercholesterolemic or antihyperlipidemic, antidiabetic and anti-inflammatory properties, which improved proteins and peptides research interest and contributed to the increase of mushroom market value. This review provides an overview of the most relevant biochemical and biological properties of the main protein groups in edible mushrooms, explicitly focusing on their biomedical potential. Although mushrooms are a rich source of various proteins, many of these molecules have yet to be identified and characterised. Accordingly, it is crucial to identify and characterise new macromolecules of macrofungi origin, which opens an opportunity for further investigation to identify new bioactives for food, nutraceutical, or medicinal applications.

Double or nothing: push and pull factors of casinos in Europe.

Gambling tourism is a subject that has been gaining a lot of interest and notoriety over the last two decades. Push and pull factors have for long been the backbone of tourism studies and this research seeks to expound on this theory within the area of casinos. In this study, 1383 google reviews from five different countries in coastal Europe: Casino Vila Moura, Algarve (Portugal), Casino Barrière Le Croisette, Cannes (France), Casino de Monte-Carlo, (Monaco), Casino Malta, (Malta), and Regency Casino Thessaloniki, (Greece) were analyzed with the software Leximancer. The main objective of this study was to identify the concepts in the reviews and then pinpoint what push and pull factor these concepts belonged to and how important this was when choosing a casino destination in Europe. The results highlight the importance of the pull factor while choosing a destination and reveals that gamers seek mainly table games as they attract both players and other tourists who tend to gather around the tables to watch. Among the greatest push-factors is the excitement of winning money in slot machines. Findings also demonstrate that casinos located in Europe offer world-class gambling services that are both engaging and fun to engage in. This study adds to earlier research by employing the push and pull motivation framework within the area of casinos based on user-generated content.

The effects of aspartame on the HTR8/SVneo extravillous trophoblast cell line.

Extravillous trophoblasts (EVTs) are a key cell type involved in placentation. Aspartame is an artificial sweetener with a widespread use. In rodents, aspartame ingestion during pregnancy was found to cause a reduction in placental and fetal weights, but its effect in placentation at a cellular level has not been studied. Aspartame is completely hydrolyzed in the gastrointestinal tract into L-phenylalanine, L-aspartic acid, and methanol. We aimed to study the effects of aspartame and its metabolites on placentation related characteristics of EVTs. For this, we exposed HTR-8/SVneo cells to aspartame (0.001, 0.01, 0.1, 0.5 and 1 mM), L-phenylalanine (0.14 and 0.5 mM), L-aspartic acid (0.82, 2.8 and 10 mM) or methanol (0.14 and 0.8 mM) for 24 h. Aspartame had an anti-proliferative effect, decreased the number of metabolically active cells and glucose cellular uptake and increased the number of cells arrested in S phase. L-aspartic acid significantly reduced glucose uptake and whole-cell protein content. L-phenylalanine had an anti-proliferative effect and increased the number of metabolically active cells. Interestingly, methanol exerted very marked effects on HTR8/SVneo cells: it showed an anti-proliferative effect, decreased glucose uptake, the migratory ability and the number of cells in the G2/M phase and increased oxidative stress levels, in concentrations corresponding to the blood levels after the 99th percentile of projected daily ingestion of aspartame. Overall, our results demonstrate that aspartame and its metabolites can affect several characteristics of EVTs and support the conclusion that the effect of aspartame in the placenta should be further evaluated.

Organoleptic Chemical Markers of Serpa PDO Cheese Specificity.

Serpa is a protected designation of origin cheese produced with a vegetable coagulant (Cynara cardunculus L.) and raw ovine milk. Despite the unique sensory profile of raw milk cheeses, numerous parameters influence their sensory properties and safety. To protect the Serpa cheese quality and contribute to unifying their distinctive features, some rheologic and physicochemical parameters of cheeses from four PDO producers, in distinct seasons and with different sensory scores, were monitored. The results suggested a high chemical diversity and variation according to the dairy, month and season, which corroborates the significant heterogeneity. However, a higher incidence of some compounds was found: a group of free amino acids (Glu, Ala, Leu, Val and Phe), lactic and acetic acids, some volatile fatty acids (e.g., iC4, iC5, C6 and C12) and esters (e.g., ethyl butanoate, decanoate and dodecanoate). Through the successive statistical analysis, 13 variables were selected as chemical markers of Serpa cheese specificity: C3, C4, iC5, C12, Tyr, Trp, Ile, 2-undecanone, ethyl isovalerate, moisture content on a fat-free basis, the nitrogen-fractions (maturation index and non-protein and total nitrogen ratio) and G' 1 Hz. These sensory markers' identification will be essential to guide the selection and development of an autochthonous starter culture to improve cheese quality and safety issues and maintain some of the Serpa authenticity.

Membrane fractionation of Cynara cardunculus swine blood hydrolysate: Ingredients of high nutritional and nutraceutical value.

This work proposes an innovative approach to valorise swine blood based on enzymatic hydrolysis and membrane fractionations. Hydrolysis with Cynara cardunculus enzymes, followed by microfiltration and double nanofiltration generated three high protein fractions, retentate of microfiltration (RMF; >0.5 µm) and retentate of nanofiltration (RNF; >3 kDa) with approximately 90% of protein on a dry basis and filtrate of nanofiltrate (FNF; <3 kDa) with 65%. FNF, rich in low molecular weight peptides, showed excellent antioxidants (ABTS and ORAC of 911.81 and 532.82 µmol TE g-1 DB, respectively) and antihypertensive (IC50 of 28.51 µg mL-1) potential. By peptidomics and in silico analysis, 43 unique sequences of interest were found, among which LVV-Hemorphin-7 was identified. This hemorphin was demonstrated as the main responsible for the observed bioactivity. Complementary results showed a prebiotic effect mainly for the growth of Bifidobacterium animalis Bo, as well as interesting free amino acids (mainly glutamic acid, leucine, alanine, phenylalanine and aspartic acid) and mineral (e.g., Ca, Mg, P, K and Na) profiles. No antibacterial effect was verified for the seven pathogenic bacteria tested. This study allowed obtaining new ingredient of high nutritional and nutraceutical value for human consumption, with a perspective of sustainability and industrial viability.

Cuidados de saúde à família em contexto de UCSP: A participação do parceiro no pré-natal: Implicação na enfermagem de família / Family health care in PHCU context: Partner's participation in prenatal care: Implications for family nursing

O presente Relatório de Estágio para obtenção do Grau de Mestre em Enfermagem de Saúde Comunitária na área de Enfermagem de Saúde Familiar (ESF) apresenta as atividades desenvolvidas nos estágios que decorreram entre setembro de 2020 e março de 2021, na Unidade de Cuidados de Saúde Personalizados (UCSP) Polo Monte Real/Carvide. Partindo do princípio que as Unidades de Saúde Familiar são o futuro das UCSP, procurei ter nestes estágios uma visão de evolução na prática de enfermagem à família. O principal objetivo deste relatório é refletir sobre os cuidados especializados de enfermagem de saúde familiar desenvolvidos em contexto clínico, tendo de base as Competências Comuns e Específicas do Enfermeiro Especialista em Enfermagem Comunitária na área de ESF. Ao longo deste trabalho, abordo: o enquadramento do contexto prático; fundamentação teórica para a prática especializada em ESF; competências do Enfermeiro Especialista nesta área; eprática especializada baseada na evidência. No último capítulo, realizei uma Revisão Integrativa da Literatura (RIL) com o tema "A Participação do Parceiro no Pré-Natal: Implicações na Enfermagem de Família", baseando o mesmo na minha experiência neste contexto prático e com vista na melhoria da qualidade doscuidados de saúde familiar. Tem como objetivo geral fornecer uma visão geral da literatura existente sobre esta temática. O incentivo da participação do "futuro pai"nas consultas pré-natal não deve ser esquecido, sendo importante para a promoção da saúde familiar. Deste modo, surge a necessidade de direcionar, também, o foco de atenção para o cuidado à família como um todo e não apenas para a mulher grávida. Após ter sido delineada a estratégia de investigação, procedeu-se à pesquisa através de algumas bases de dados (B-On; LILACS; PubMed®; e RECAAP), utilizando os descritores do DeCS e MeSH e o operador booleano "AND". Foram selecionados 13 estudos. As conclusões obtidas desta revisão são: existem benefícios claros da participação do parceiro no pré-natal, tanto para a mulher, para o bebé, para o parceiro, bem como para a família no seu todo. Apesar disto, podem haver barreiras na participação dos pais. A principal conclusão da RIL é que podemos considerar de grande relevância a promoção da participação do parceiro nas consultas de saúde materna, sendo que os estudos destacaram que a abordagem do profissional pode melhorar ou reduzir as experiências de inclusão no pré-natal.

This Internship Report for obtaining the Master's Degree in Community Health Nursing in the area of Family Health Nursing presents the activities carried out in the internships that took place between September 2020 and March 2021, at the Personalized Health Care Unit in Monte Real/Carvide. Assuming that Family Health Units are the future of Personalized Health Care Unit, I have tried to include in these stages a vision of evolution in family nursing practice. The main objective of this report is to reflect on the specialized care of family health nursing developed in a clinical context, based on the Common and Specific Competencies of the Nurse Specialist in Community Nursing in the area of Family Health Nursing. Throughout this work, I have developed: the framing of the practical context; the theoretical foundation for the specialized practice in Family Health Nursing; competences of the Specialist Nurse in this area; and evidence-based expert practice. In the last chapter, I have carried out an Integrative Literature Review with the theme "Partner Participation in Prenatal: Implications in Family Nursing", taking into account my experience in the practical context and with a view to improving the quality of family health care. The main objective is to provide an overview of the existing literature on this topic. Encouraging the participation of the "future father" in prenatal consultations should not be forgotten, as it is important for the promotion of family health. In this way, the need arises to also direct the focus of attention to care for the family as a whole and not just for the pregnant woman. After the investigation strategy had been outlined, a search was carried out through some databases (B-On; LILACS; PubMed®; e RECAAP), using DeCS and MeSH descriptors and the Boolean operator "AND". 13 studies were selected. The conclusions drawn from this review are: there are clear benefits of partner participation in prenatal, both for the woman, the baby, the partner, as well as the family as a whole. Despite this, there may be barriers to parental participation. The main conclusion of the review is that we can consider the promotion of partner participation in maternal health consultations of great relevance, and studies have highlighted that the professional's approach can improve or reduce the experiences of inclusion in prenatal care.

Evaluation of the Biological Potential of Himanthalia elongata (L.) S.F.Gray and Eisenia bicyclis (Kjellman) Setchell Subcritical Water Extracts.

Neuroprotection is a need that remains unmet in treating chronic neurodegenerative disorders, despite decades of extensive research. To find new neuroprotective compounds, extracts of Himanthalia elongata (L.) S.F.Gray and of Eisenia bicyclis (Kjellman) Setchell were obtained through subcritical water extraction applying a four-step temperature gradient. The fractions obtained were screened against brain enzymes involved in neurodegenerative etiology, namely in Alzheimer's and Parkinson's diseases, and against reactive oxygen and nitrogen species, all contributing factors to the progression of neurodegeneration. Results showed no significant enzyme inhibition but strong radical scavenging activities, particularly in the fourth fraction, extracted at the highest temperature (250 °C), highlighting their ability to retard oxidative and nitrosative stresses. At higher temperatures, fractions were composed of phenolic compounds and Maillard reaction products, a combination that contributed to their antioxidant activity and, consequently, their neuroprotective properties. All fractions were evaluated for the presence of iodine, 14 organochlorine and 7 organophosphorus pesticides, and pharmaceuticals used in Alzheimer's and Parkinson's diseases (14), psychiatric drugs (8), and metabolites (8). The fractions studied did not present any of the screened contaminants, and only fraction 1 of E. bicyclis should be used with caution due to iodine content.

Hosting in turbulent times: Hoteliers' perceptions and strategies to recover from the Covid-19 pandemic.

This research examines hoteliers' perceptions and strategies in light of the Covid-19 pandemic and their predictions about an uncertain industry that has shifted attention to safety and hygiene concerns to regain guests' trust. A cross-sectional study comprised of four assessments with hoteliers worldwide (Nstudy 1 = 144; Nstudy2 = 100; Nstudy3 = 97; Nstudy4 = 66) was conducted between April and June 2020. Hoteliers' forecasts and operating procedures were assessed in light of crisis management, providing important insights for researchers and the hotel industry. Remarkably, most of the hoteliers predict that the crisis is recoverable and believe that sales revenue will reach 2019 levels in 2021. They have implemented extraordinary recovery measures to make up for the loss of revenue caused by the crisis. From special health and safety protocols to long-term vouchers to promote reservations, strategic efforts to recover from the pandemic are ongoing.

Impact of Processing Approach and Storage Time on Bioactive and Biological Properties of Rocket, Spinach and Watercress Byproducts.

The high nutritional value of vegetables is well recognized, but their short shelf life and seasonal nature result in massive losses and wastes. Vegetable's byproducts are an opportunity to develop value-added ingredients, increasing food system efficiency and environmental sustainability. In the present work, pulps and powders of byproducts from rocket and spinach leaves and watercress were developed and stored for six months under freezing and vacuum conditions, respectively. After processing and storage, microbiological quality, bioactive compounds (polyphenols, carotenoids and tocopherols profiles), antioxidant capacity, and pulps viscosity were analyzed. Generally, the developed vegetable's pulps and powders were considered microbiologically safe. Although some variations after processing and storage were verified, the antioxidant activity was preserved or improved. A rich phenolic composition was also registered and maintained. During freezing, the quantitative carotenoid profile was significantly improved (mainly in rocket and spinach), while after drying, there was a significant decrease. A positive effect was verified in the vitamin E level. Both processing and storage conditions resulted in products with relevant phenolics, carotenoids and tocopherol levels, contributing to the antioxidant activity registered. Thus, this study demonstrates the potential of vegetable byproducts valorization through developing these functional ingredients bringing economic and environmental value into the food chain.

Multimodal Interaction between a Mother and Her Twin Preterm Infants (Male and Female) in Maternal Speech and Humming during Kangaroo Care: A Microanalytical Case Study.

The literature reports the benefits of multimodal interaction with the maternal voice for preterm dyads in kangaroo care. Little is known about multimodal interaction and vocal modulation between preterm mother-twin dyads. This study aims to deepen the knowledge about multimodal interaction (maternal touch, mother's and infants' vocalizations and infants' gaze) between a mother and her twin preterm infants (twin 1 [female] and twin 2 [male]) during speech and humming in kangaroo care. A microanalytical case study was carried out using ELAN, PRAAT, and MAXQDA software (Version R20.4.0). Descriptive and comparative analysis was performed using SPSS software (Version V27). We observed: (1) significantly longer humming phrases to twin 2 than to twin 1 (p = 0.002), (2) significantly longer instances of maternal touch in humming than in speech to twin 1 (p = 0.000), (3) a significant increase in the pitch of maternal speech after twin 2 gazed (p = 0.002), and (4) a significant increase of pitch in humming after twin 1 vocalized (p = 0.026). This exploratory study contributes to questioning the role of maternal touch during humming in kangaroo care, as well as the mediating role of the infant's gender and visual and vocal behavior in the tonal change of humming or speech.