Multireader comparison of contrast-enhanced mammography versus the combination of digital mammography and digital breast tomosynthesis in the preoperative assessment of breast cancer.

PURPOSE: To compare preoperative contrast-enhanced spectral mammography (CEM) versus digital mammography plus digital breast tomosynthesis (DM + DBT) in detecting breast cancer (BC) and assessing its size. MATERIAL AND METHODS: We retrospectively included 78 patients with histological diagnosis of BC who underwent preoperative DM, DBT, and CEM over one year. Four readers, blinded to pathology and clinical information, independently evaluated DM + DBT versus CEM to detect BC and measure its size. Readers' experience ranged 3-10 years. We calculated the per-lesion cancer detection rate (CDR) and the complement of positive predictive value (1-PPV) of both methods, stratifying analysis on the total of lesions, index lesions, and additional lesions. The agreement in assessing cancer size versus pathology was assessed with Bland-Altman analysis. RESULTS: 100 invasive BCs (78 index lesions and 22 additional lesions) were analyzed. Compared to DM + DBT, CEM showed higher overall CDR in less experienced readers (range 0.85-0.90 vs. 0.95-0.96), and higher CDR for additional lesions, regardless of the reader (range 0.54-0.68 vs. 0.77-0.86). CEM increased the detection of additional disease in dense breasts in all readers and non-dense breasts in less experienced readers only. The 1-PPV of CEM (range 0.10-0.18) was comparable to that of DM + DBT (range 0.09-0.19). At Bland-Altman analysis, DM + DBT and CEM showed comparable mean differences and limits of agreement in respect of pathologic cancer size. CONCLUSION: Preoperative CEM improved the detection of additional cancer lesions compared to DM + DBT, particularly in dense breasts. CEM and DM + DBT achieved comparable performance in cancer size assessment.

Bioactive Potential of Minor Italian Olive Genotypes from Apulia, Sardinia and Abruzzo.

This research focuses on the exploration, recovery and valorization of some minor Italian olive cultivars, about which little information is currently available. Autochthonous and unexplored germplasm has the potential to face unforeseen changes and thus to improve the sustainability of the whole olive system. A pattern of nine minor genotypes cultivated in three Italian regions has been molecularly fingerprinted with 12 nuclear microsatellites (SSRs), that were able to unequivocally identify all genotypes. Moreover, some of the principal phenolic compounds were determined and quantified in monovarietal oils and the expression levels of related genes were also investigated at different fruit developmental stages. Genotypes differed to the greatest extent in the content of oleacein (3,4-DHPEA-EDA) and total phenols. Thereby, minor local genotypes, characterized by stable production and resilience in a low-input agro-system, can provide a remarkable contribution to the improvement of the Italian olive production chain and can become very profitable from a socio-economic point of view.

Environmental Impact of Food Preparations Enriched with Phenolic Extracts from Olive Oil Mill Waste.

Reducing food waste as well as converting waste products into second-life products are global challenges to promote the circular economy business model. In this context, the aim of this study is to quantify the environmental impact of lab-scale food preparations enriched with phenolic extracts from olive oil mill waste, i.e., wastewater and olive leaves. Technological (oxidation induction time) and nutritional (total phenols content) parameters were considered to assess the environmental performance based on benefits deriving by adding the extracts in vegan mayonnaise, salad dressing, biscuits, and gluten-free breadsticks. Phenolic extraction, encapsulation, and addiction to the four food preparations were analyzed, and the input and output processes were identified in order to apply the life cycle assessment to quantify the potential environmental impact of the system analyzed. Extraction and encapsulation processes characterized by low production yields, energy-intensive and complex operations, and the partial use of chemical reagents have a non-negligible environmental impact contribution on the food preparation, ranging from 0.71% to 73.51%. Considering technological and nutritional aspects, the extraction/encapsulation process contributions tend to cancel out. Impacts could be reduced approaching to a scale-up process.

Technological, Nutritional and Sensory Properties of an Innovative Gluten-Free Double-Layered Flat Bread Enriched with Amaranth Flour.

Celiac disease is increasing all over the world. In this context, most recent research in this area is addressing and attempting to improve the nutritional value and sensory characteristics of gluten-free (GF) food products and to enhance their technological properties. Here, amaranth flour was studied as a potential healthy ingredient for the development of an innovative GF flat bread. Starting from two different basic formulations (rice flour:corn starch and rice flour:tapioca starch, 50:50), the impact of partially replacing rice flour (6%) and starch (6%) with amaranth on the nutritional characteristics, polyphenol composition, textural, and sensory properties of the resulting GF flat breads was explored. The substitution with amaranth led to detrimental effects on the doughs' viscometric properties, especially in the case of tapioca starch, but significantly improved the doughs' textural properties. All the amaranth-enriched flat breads showed a better color and a significant increase in all polyphenols fractions but lower antioxidant activity. During bread storage for three days, a detrimental effect on both starch retrogradation, toughness, and extensibility properties were observed, especially when tapioca starch was used. Check-all-that-apply (CATA) sensory test results showed that the incorporation of amaranth increased yeast odor and yeast flavor perception and decreased the softness in mouth-only in tapioca-based samples. A better compromise among technological, nutritional, and sensory properties was achieved when amaranth flour was added to the basic rice and corn formulation.

Gluten-Free Breadsticks Fortified with Phenolic-Rich Extracts from Olive Leaves and Olive Mill Wastewater.

Nowadays, food processing by-products, which have long raised serious environmental concerns, are recognized to be a cheap source of valuable compounds. In the present study, incorporation of phenolic-rich extracts (500 and 1000 mg kg-1) from olive leaves (OL) and olive mill wastewater (OMW) into conventional gluten-free formulations has been exploited as a potential strategy for developing nutritious and healthy breadsticks with extended shelf-life. To this end, moisture, water activity (aw), visual and textural properties, the composition of biologically active compounds (soluble, insoluble, and bio-accessible polyphenols), antioxidant activity, oxidation stability, and consumer preference of the resulting breadsticks were investigated. Fortified breadsticks had higher moisture and aw, lower hardness, and similar color in comparison to the control, especially in the case of OL extract supplementation. All enriched formulations significantly affected the phenolic composition, as evidenced by the decrease in insoluble/soluble polyphenols ratio (from 7 in the control up to 3.1 and 4.5 in OL and OMW, respectively), and a concomitant increase in polyphenol bio-accessibility (OL: 14.5-23% and OMW: 10.4-15% rise) and antioxidant activity (OL: 20-36% and OMW: 11-16% rise). Moreover, a significant shelf-life extension was observed in all fortified breadsticks (especially in case of OMW supplementation). Sensory evaluation evidenced that 61% of the assessors showed a marked, but not significant, tendency to consider the sample supplemented with high levels of OL as a more palatable choice.

Effect of Substitution of Rice Flour with Quinoa Flour on the Chemical-Physical, Nutritional, Volatile and Sensory Parameters of Gluten-Free Ladyfinger Biscuits.

The present study investigates the effect of partial or total substitution of rice flour (RF) with quinoa flour (QF) (at 25%, 50%, 75% and 100%) on the chemical-physical, nutritional, and sensory characteristics, as well as the volatile compounds, of ladyfinger biscuits. All quinoa-based formulations positively affected the crust colour, endowing it with lower 'lightness' and higher 'redness' values, giving the biscuits a more appealing crust colour. Biscuits with higher percentages of QF also had better structure, as they were softer. The substitution of RF with QF significantly improved the nutritional profile of the biscuits, as a result of the increase in protein, lipid, ash, total soluble (SP) and insoluble polyphenol (IP), flavonoid, and antioxidant activity levels, which increased linearly with the substitution rate. Quinoa supplementation led to an increase in volatile compounds that were nearly always characterised by positive olfactory attributes. Sensory analysis revealed that the maximal substitution rate of QF able to maintain an adequate consumer acceptability rating is probably 50%, as higher percentages impaired acceptability due to the presence of herbaceous and bitter tastes, even if the consumers also rated these samples as healthier and softer to touch.

Table Olives: An Overview on Effects of Processing on Nutritional and Sensory Quality.

Table olives are a pickled food product obtained by a partial/total debittering and subsequent fermentation of drupes. Their peculiar sensory properties have led to a their widespread use, especially in Europe, as an appetizer or an ingredient for culinary use. The most relevant literature of the last twenty years has been analyzed in this review with the aim of giving an up-to-date overview of the processing and storage effects on the nutritional and sensory properties of table olives. Analysis of the literature has revealed that the nutritional properties of table olives are mainly influenced by the processing method used, even if preharvest-factors such as irrigation and fruit ripening stage may have a certain weight. Data revealed that the nutritional value of table olives depends mostly on the balanced profile of polyunsaturated and monounsaturated fatty acids and the contents of health-promoting phenolic compounds, which are best retained in natural table olives. Studies on the use of low salt brines and of selected starter cultures have shown the possibility of producing table olives with an improved nutritional profile. Sensory characteristics are mostly process-dependent, and a relevant contribute is achieved by starters, not only for reducing the bitterness of fruits, but also for imparting new and typical taste to table olives. Findings reported in this review confirm, in conclusion, that table olives surely constitute an important food source for their balanced nutritional profile and unique sensory characteristics.

A Life Cycle Perspective to Assess the Environmental and Economic Impacts of Innovative Technologies in Extra Virgin Olive Oil Extraction.

Advances in the adoption of technological innovations represent a great driver to improve the competitiveness of the Italian extra virgin olive oil (EVOO) industry. This work assesses the efficiency of an innovative extraction plant (with low oxidative impact, heating of paste before malaxation and a special decanter that avoids the final vertical centrifugation) in terms of oil yield and quality, and economic and environmental impacts. Economic and environmental impacts were evaluated by using both life cycle costing and life cycle assessment methodologies. A sensitivity analysis was also performed to highlight the uncertain factors that may strongly affect the results. Findings showed that olive milling with the innovative plant resulted in olive oil with a significant increase in quality, although the extraction yield was significantly higher when using conventional technology. In terms of environmental results, an average growth of 4.5% of the impacts in all categories was reached. The economic results revealed the highest extraction cost for the innovative scenario as well as the lower profitability, although a positive return in investment feasibility can be achieved due to an increase in the olive oil selling price. These findings could be useful to highlight the main hotspots in EVOO production and to suggest improvements for more sustainable management.

Techno-functional and nutritional performance of commercial breads available in Europe.

In recent years, the growing interest for well-being and healthy lifestyle together with an increasing awareness of the close relationship between food and health have boosted the production of an increasing number of novel goods to be placed in both gluten-containing and gluten-free products market. The objective of this study was to provide a realistic and detailed overview of the current bread-market supply in order to evaluate the overall quality of the available offer in this prioritized food industry area. Twenty commercial breads consisting of gluten (n = 10) and gluten-free (n = 10) samples currently available in the European market have been assessed by physical-chemical, technological, nutritional, and sensory determinations. The quality parameters obtained were related to each other by using Pearson correlations, while sample classification was achieved by applying factor analysis. Higher values for protein and bio-accessible polyphenols content, aroma and taste quality, and low and moderate expected glycaemic index corresponded to gluten containing breads. Although the main distinction was between gluten and gluten-free samples as it was expected, classification of breads allowed differentiating samples with different formulations in terms of presence/absence of alternative, innovative, and nutrient-dense raw materials.

Impact of ancient cereals, pseudocereals and legumes on starch hydrolysis and antiradical activity of technologically viable blended breads.

Wheat flour replacement from 22.5% up to 45% by incorporation of ternary blends of teff (T), green pea (GP) and buckwheat (BW) flours provided technologically viable and acceptable sensory rated multigrain breads with superior nutritional value compared to the 100% wheat flour (WT) counterparts. Blended breads exhibited superior nutritional composition, larger amounts of bioaccessible polyphenols, higher anti-radical activity, and lower and slower starch digestibility. Simultaneous lower rapidly digestible starch (57.1%) and higher slowly digestible starch (12.9%) and resistant starch (2.8%) contents (g per 100g fresh bread), considered suitable nutritional trends for dietary starch fractions, were met by the blend formulated 7.5% T, 15% GP, 15% BK. The associated mixture that replaced 37.5% WT, showed a rather lower extent and slower rate of starch hydrolysis with medium-low values for C∞, and H90, and lowest k, and intermediate expected Glycaemic Index (86). All multigrain breads can be labelled as source of dietary fibre (≥ 3 g dietary fibre/100g bread).

Procedural distress in children with cancer: self-report, behavioral observations, and physiological parameters.

OBJECTIVES: To examine the relationship among different indicators of pain and distress, including self-report, behavioral observations, and physiological parameters, in children with cancer undergoing invasive procedures. METHODS: Forty-eight children between the ages of 3.1 and 17.7 years were evaluated while undergoing lumbar punctures. Self-report measures assessed anxiety, pain, self-efficacy, expectations of coping strategies, and coping self-efficacy. Parents reported on their own and their child's levels of anxiety, and physicians estimated their own level of stress and technical difficulty in completing the procedure. Behavioral observations were made prior to, during, and after the procedure. Physiological parameters included heart rate, cardiac vagal tone, and salivary cortisol. At the discretion of attending physicians, 32 children received deep sedation, 9 received light sedation, and 7 received cognitive-behavioral strategies with topical anesthetic as interventions to manage procedural distress. RESULTS: There was a high degree of consistency within self-report, behavioral, and physiological parameters, but correlations between measures in different modalities were low. There were floor effects for most behavioral and self-report measures of distress. Cortisol showed marked changes preprocedure to postprocedure, demonstrating high levels of physiological response despite lack of apparent or perceived discomfort. Heart rate was significantly lower in the group using cognitive-behavioral techniques, especially at the point of needle insertion. DISCUSSION: Self-report measures, behavioral indicators, and physiological changes are not interchangeable outcomes. Treatment strategies were effective for minimizing subjective and behavioral distress, but not necessarily for physiological reactions. Future research should focus on individual differences in these responses, and treatment outcome studies aimed at reducing distress must be clear about the specific goals of intervention.

Temperament and stress response in children with juvenile primary fibromyalgia syndrome.

OBJECTIVE: To examine temperament, stress response, child psychological adjustment, family environment, pain sensitivity, and stress response differences between children and adolescents with juvenile primary fibromyalgia syndrome (JPFMS), children with arthritis, and healthy controls. Parental psychological adjustment was also measured. METHODS: Subjects included 16 children with JPFMS, 16 children with arthritis, and 16 healthy controls. Participants completed the Dimensions of Temperament Survey-Revised (DOTS-R), State-Trait Anxiety Inventory, Children's Depression Inventory, Family Environment Scale (FES), Sensitivity Temperament Inventory for Pain (STIP), and Youth Self-Report. Responsiveness to an acute stressor was assessed by measuring salivary cortisol levels before and after venipuncture. Parents were asked to complete the parent versions of the DOTS-R, FES, STIP, Child Behavior Checklist, and Symptom Checklist-90-Revised. RESULTS: Children and adolescents with JPFMS demonstrated more temperamental instability, increased levels of depression and anxiety, less family cohesion, and higher pain sensitivity compared with the other 2 groups. Parents of children with JPFMS, in rating themselves, also reported higher levels of anxiety and depression, and lower overall psychological adjustment compared with parents of children in the other groups. CONCLUSION: These results suggest that a psychobiologic perspective may contribute to an increased understanding of JPFMS in children and adolescents, facilitating an approach to investigating the interaction of factors that appear to place a child at risk for development of a pain syndrome. Because temperamental instability, sensitivity to pain, vulnerability to stress, psychological adjustment, family context, and parental psychopathology are individual risk factors, the interaction of these factors may explain the breadth of symptoms associated with this pain syndrome, as well as its severity.