High-Pressure Processing Effects on Microbiological Stability, Physicochemical Properties, and Volatile Profile of a Fruit Salad.

Nowadays, consumers are more aware of the effects of their diet on their health, and thus demand natural or minimally processed food products. Therefore, research has focused on processes that assure safe products without jeopardizing their nutritional properties. In this context, this work aimed to evaluate the effects of high-pressure processing (550 MPa/3 min/15 °C, HPP) on a fruit salad (composed of melon juice and pieces of Golden apple and Rocha pear) throughout 35 days of storage at 4 °C. For the physicochemical properties analysed (browning degree, polyphenol oxidase activity, antioxidant activity (ABTS assay), and volatile profile), a freshly made fruit salad was used, while for the microbiological tests (total aerobic mesophiles, and yeast and moulds) spoiled melon juice was added to the fruit salad to increase the microbial load and mimic a challenge test with a high initial microbial load. It was determined that processed samples were more microbiologically stable than raw samples, as HPP enabled a reduction of almost 4-log units of both total aerobic mesophiles and yeasts and moulds, as well as an almost 1.5-fold increase in titratable acidity of the unprocessed samples compared to HPP samples. Regarding browning degree, a significant increase (p < 0.05) was observed in processed versus unprocessed samples (roughly/maximum 68%), while the addition of ascorbic acid decreased the browning of the samples by 29%. For antioxidant activity, there were no significant differences between raw and processed samples during the 35 days of storage. An increase in the activity of polyphenol oxidase immediately after processing (about 150%) was confirmed, which was generally similar or higher during storage compared with the raw samples. Regarding the volatile profile of the product, it was seen that the compounds associated with melon represented the biggest relative percentage and processed samples revealed a decrease in the relative quantity of these compounds compared to unprocessed. Broadly speaking, HPP was shown to be efficient in maintaining the stability and overall quality of the product while assuring microbial safety (by inactivating purposely inoculated microorganisms), which allows for longer shelf life (7 versus 28 days for unprocessed and processed fruit salad, respectively).

Pachydysostosis of the fibula in a case of familial adenomatous polyposis.

BACKGROUND: Familial Adenomatous Polyposis (FAP) is a colorectal cancer (CRC) predisposition syndrome caused by germline APC mutations and characterised by an increased risk of CRC and colonic polyps and, in certain forms, of specific prominent extraintestinal manifestations, namely osteomas, soft tissue tumours and dental anomalies. Pachydysostosis of the fibula is a rare clinical entity defined by unilateral bowing of the distal portion of the fibula and elongation of the entire bone, without affectation of the tibia. CLINICAL REPORT: We report a 17-year-old male, who presented with a non-progressive bowing of the right leg detected at 18 months of age caused by a fibula malformation (later characterized as pachydysostosis) and a large exophytic osteoma of the left radius, noticed at the age of 15 years, without gastrointestinal symptoms. There was no relevant family history. Detailed characterisation revealed multiple osteomas, skin lesions and dental abnormalities, raising the hypothesis of FAP. This diagnosis was confirmed by genetic testing [c.4406_4409dup p.(Ala1471Serfs*17) de novo mutation in the APC gene] and endoscopic investigation (multiple adenomas throughout the colon, ileum and stomach). DISCUSSION: This case report draws attention to the phenotypic spectrum of skeletal manifestations of FAP: this patient has a congenital fibula malformation, not previously associated with this syndrome, but which is likely to have been its first manifestation in this patient. This clinical case also illustrates the challenges in the early diagnosis of FAP, especially without family history, and highlights the importance of a multidisciplinary approach and the adequate study of rare skeletal abnormalities.

Modulation of Lipid Profile and Lipoprotein Subfractions in Overweight/Obese Women at Risk of Cardiovascular Diseases through the Consumption of Apple/Berry Juice.

Polyphenol-rich foods protect the cellular systems of the human body from oxidative damage, thereby reducing the risk of chronic diseases such as cardiovascular disease (CVD). We investigated the effect of phenolic-rich apple/berry juice (chokeberry, blueberry, and cranberry) on lipidemic profiles in overweight/obese women. The 6 week single-arm pre-post intervention study involved 20 women (mean age 52.95 ± 5.8 years, body mass index ≥25 kg/m2, and ≥1 CVD risk factors) consuming 300 mL/day of the apple/berry juice. Lipid profile, low-density lipoprotein (LDL) subfractions assessed using Lipoprint® electrophoresis, and other parameters related to cardiovascular risk (C-reactive protein, glucose, blood pressure) were analyzed before and again after the intervention in the monitored group of women. High-density lipoprotein cholesterol (HDL-C) increased from 1.30 ± 0.29 to 1.55 ± 0.32, magnesium from 0.85 ± 0.03 to 0.90 ± 0.05, and total antioxidant status from 1.68 ± 0.08 to 1.81 ± 0.10. The LDL/HDL ratio significantly decreased from 3.40 ± 0.99 to 2.66 ± 0.63 mmol/L, and the glucose from 5.50 ± 0.72 to 5.24 ± 0.74 mmol/L. However, the hs-CRP did not change significantly. Women with atherogenic subfractions LDL3-7 at baseline (n = 6) showed a significant reduction from 0.45 ± 0.19 to 0.09 ± 0.07 mmol/L. Overweight/obese women may benefit from apple/berry juice as part of a healthy lifestyle to improve their lipid profile, and thus, contribute to cardiovascular health.

Trisomy 18-when the diagnosis is compatible with life.

Trisomy 18 is an autosomal chromosomal disorder characterized by the presence of an extra 18 chromosome. In the last decades, and as novel therapeutic options emerged, a paradigm shift on the treatments available to these children occurred, establishing the need to deepen the knowledge regarding the management/treatment of children diagnosed with trisomy 18. This retrospective cohort study sought to characterize the clinical path and survival of the children with the diagnosis of trisomy 18 followed in a tertiary pediatric hospital between 1995 and 2020. Medical records were reviewed, and epidemiological and clinical features and follow-up data were collected. Six patients were identified, two with mosaicism (33.3%) and four were female (66.7%). All had cardiovascular, cognitive, and physical development anomalies or minor congenital anomalies. Most presented neurological anomalies (n = 4, 66.7%) and feeding difficulties (n = 4, 66.7%). Four children (66.7%) required medical devices or equipment and all required chronic medication. Two children (33.3%) underwent surgical interventions. Four children (66.7%) were hospitalized in the last year of life. Three patients had a do not resuscitate order (50%) but only one child was referred to a pediatric palliative care team (16.7%). One-month, 1-year, and 10-year survival were 66.7% (n = 4), 33.3% (n = 2, both with mosaicism), and 16.7% (n = 1, with mosaicism) respectively. CONCLUSIONS: Knowledge of the multiple comorbidities and complex care needs of children with this syndrome is crucial. Every-day care and decisions about invasive treatments may raise ethical issues. Early referral to pediatric palliative care teams is essential to promote a holistic advanced care plan for both the patient and his family. WHAT IS KNOWN: • The increase in survival and the high morbimortality that trisomy 18 still entails demands a careful deliberation on the use of invasive treatment. WHAT IS NEW: • Recent studies show that the labels of "incompatible with life"/"lethal" are not adequate, establishing a need to change this mindset. • The development of pediatric palliative care teams in the last decade and early referral allow for an optimal individualized advanced care plan. Under-referral to pediatric palliative care teams persists and efforts must be made to increase awareness of their existence and role in patient care.

Frequency of cystoid macular edema and vitreomacular interface disorders in genetically solved syndromic and non-syndromic retinitis pigmentosa.

PURPOSE: Retinitis pigmentosa (RP) corresponds to a group of inherited retinal disorders where progressive rod-cone degeneration is observed. Cystoid macular edema (CME) and vitreomacular interface disorders (VMID) are known to complicate the RP phenotype, challenging an age-old concept of retained central visual acuity. The reported prevalence of these changes varies greatly among different studies. We aim to describe the frequency of CME and VMID and identify predictors of these changes in a cohort of Caucasian patients with genetically solved syndromic (sRP) and non-syndromic RP (nsRP). METHODS: Cross-sectional study of patients with genetically solved sRP or nsRP. Genetic testing was clinically oriented in all probands and coordinated by a medical geneticist. The presence/absence of CME and VMIDs such as epiretinal membrane (ERM), vitreomacular traction (VMT), lamellar hole (LH), macular hole (MH), and macular pseudohole (MPH), and the integrity of the neurosensory retina and retinal pigment epithelium were evaluated in individual macular SD-OCT b-scans. Mixed-effects regression analysis models were used to identify significant predictors of BCVA, CME, and VMID. Significance was considered at α < 0.05. RESULTS: We included 250 eyes from 125 patients. Mean age was 44.9 ± 15.7 years and 55.2% were male. Eighty-eight patients had nsRP and 37 had sRP. Median BCVA was 0.5 (0.2-1.3) logMAR. CME was found in 17.1% of eyes, while ERM was found in 54.3% of eyes. The frequency of CME (p = 0.45) and ERM (p = 0.07) did not differ between sRP and nsRP patients, nor across different inheritance patterns. Mixed-effects univariate linear regression identified age (p = 0.04), cataract surgery (p < 0.01), and loss of integrity of outer retinal layers (p < 0.01) as significant predictors of lower visual acuity, while increased foveal thickness (p < 0.01) and the presence of CME (p = 0.04) were predictors of higher visual acuity. On mixed-effects multivariable analysis, only increased foveal thickness was significantly associated with better visual acuity (p < 0.01). CONCLUSION: We found that the burden of ERM and CME in RP patients is high, highlighting the importance of screening for these potentially treatable conditions to improve the quality of life of RP patients.

Role of Honey in Advanced Wound Care.

Honey is a natural product rich in several phenolic compounds, enzymes, and sugars with antioxidant, anticarcinogenic, anti-inflammatory, and antimicrobial potential. Indeed, the development of honey-based adhesives for wound care and other biomedical applications are topics being widely investigated over the years. Some of the advantages of the use of honey for wound-healing solutions are the acceleration of dermal repair and epithelialization, angiogenesis promotion, immune response promotion and the reduction in healing-related infections with pathogenic microorganisms. This paper reviews the main role of honey on the development of wound-healing-based applications, the main compounds responsible for the healing capacity, how the honey origin can influence the healing properties, also highlighting promising results in in vitro and in vivo trials. The challenges in the use of honey for wound healing are also covered and discussed. The delivery methodology (direct application, incorporated in fibrous membranes and hydrogels) is also presented and discussed.

Juvenile Paget's Disease: Report of a successful treatment throughout the complete growth of a patient with a missense TNFRSF11B mutation.

INTRODUCTION: Juvenile Paget's Disease (JPD) is an ultra-rare inherited osteopathy featuring markedly accelerated bone turnover. Several clinical characteristics have been reported, including bone deformities developing in childhood and hearing loss. CASE REPORT: We report the case of a 2 ¾-year-old girl that presented with progressive bowing of both legs since the age of 2, lower limb pain and frequent falls with one consequent femur fracture. Plain radiographs revealed osteoectasia of the long bone's diaphysis, and laboratory tests showed extremely high serum total alkaline phosphatase levels. A missense mutation on the gene TNFRSF11B was identified in homozygosity, and the diagnosis of JPD was made. Treatment with bisphosphonates was initiated early and markedly improved lower limb bowing and pain. The patient reached adulthood with normal height, minor bone deformities, and no functional impairment. Despite the good skeletal symptom's response, bisphosphonates failed to prevent or improve sensorineural hearing loss. CONCLUSIONS: In this clinical case, early treatment with bisphosphonates was effective for the treatment of JPD skeletal deformities. New therapeutic strategies need to be developed to better control the extraskeletal manifestations of JPD.

The effects of addition of functional monomers and molecular imprinting on dual drug release from intraocular lens material.

Although cataract surgery is considered a safe procedure, post-surgery complications such as endophthalmitis and ocular inflammation, may occur. To prevent this, antibiotics and anti-inflammatories are prescribed in the form of eye drops during the post-operatory period, but they lead to a low drug bioavailability in target tissues. The objective of this work is to develop an intraocular lens (IOL) material to deliver simultaneously one antibiotic, moxifloxacin (MXF), and one anti-inflammatory, diclofenac (DFN), in therapeutic concentrations to prevent both complications. The IOL material was modified through the incorporation of functional monomers, as well as molecular imprinting with both drugs using the same functional monomers, namely acrylic acid (AA), methacrylic acid (MAA), 4-vinylpiridine (4-VP) and a combination of MAA + 4-VP. The best results were obtained with MAA. Molecular imprinting did not influence the drug release, except with AA. Application of a mathematical model predicted that the released MXF and DFN concentrations would stay above the pre-determined MIC of S. aureus and S. epidermidis and the minimum values of IC50 of COX-1 and COX-2, for 9 and 14 days, respectively. Antibacterial tests showed that the released antibiotic remained active. The physical properties of the drug-loaded MAA-hydrogel remained adequate. The developed system proved to be non-irritant and non-cytotoxic.

Effect of High Hydrostatic Pressure Extraction on Biological Activities and Phenolics Composition of Winter Savory Leaf Extracts.

Satureja montana L. has several biological properties related to its diverse composition of secondary metabolites. Nevertheless, it has been mainly studied for its essential oil, with only a few studies on the profile and bioactivities of the bioactive compounds from its leaf extracts being reported. This work aimed to study the antioxidant activity (by oxygen radical absorbance capacity (ORAC) assay), antimicrobial minimum inhibitory and bactericidal concentrations (MIC and MBC) determination, antibiofilm (by colorimetry), impact upon DNA (anti- and pro-oxidant assay), and cytotoxicity (by cell metabolism viability assays) of S. montana extracts obtained by high-pressure-assisted extraction (HPE). The extract obtained at 348 MPa, 35% (v/v) ethanol presented the highest concentration of individual phenolic compounds, and a minimum bactericidal concentration of 20 mg/mL against Listeria monocytogenes. HPE extracts showed antioxidant activity not only in ORAC but they were also able to prevent/attenuate peroxide-induced damage upon DNA. Moreover, on its own, HPE extract induced less oxidative damage than the control extract. Concerning the cytotoxicity, HPE extracts (at 0.5 and 1.0 mg/mL) were not harmful to HT29 cell lines, while control extracts (obtained at atmospheric pressure) at higher concentrations (>1.0 mg/mL) slightly reduced the metabolism of the cells. Finally, all extracts showed inhibition of the viability of 3 cancerous cell lines (>2.0 mg/mL for Caco-2, HeLa, and TR146) to below 15%.

Dual drug delivery from hydrophobic and hydrophilic intraocular lenses: in-vitro and in-vivo studies.

Posterior capsule opacification (PCO) still remains the most frequent long term complication after cataract surgery, while endophthalmitis is rare but severe and should be prevented at all cost. Intraocular lenses (IOLs) with different designs (eg. edge and body-haptics angle) and materials (acrylic hydrophobic and acrylic hydrophilic surfaces) have been studied to reduce PCO. For the prevention of endophthalmitis, intracameral injection followed or not by topical treatment with antibiotics and anti-inflammatories are usually prescribed. The objective of this work was to investigate the use of IOLs as controlled release platforms of two drugs, the antibiotic moxifloxacin (MXF) and the anti-inflammatory ketorolac (KTL) that could advantageously substitute the usual treatment. Two types of IOLs were chosen, hydrophobic and hydrophilic. Hydrophobic IOLs have shown better results in the prevention of PCO because they adhere better to the posterior capsular bag, while hydrophilic IOLs are advised in the case of patients with uveitis, glaucoma or diabetes. The IOLs were loaded with MXF + KTL and sterilized by high hydrostatic pressure. Both IOLs reduced the tendency for adhesion of LECs. In vivo tests were done to compare the concentration of the drugs in the aqueous humor obtained after eye drops administration and drug-loaded IOLs implantation. The developed IOLs were able to release MXF and KTL at therapeutic levels, in a sustained way, which contrasts with the eye drops prophylaxis. No PCO signs were detected and histological analyses demonstrated biocompatibility of these devices.

Freezing of edible flowers: Effect on microbial and antioxidant quality during storage.

Edible flowers are a new gourmet product; however, they are not always available all years. Thus, it is essential to find out technologies to guarantee this product for a longer time. Flowers of four species (borage [Borago officinalis], heartsease [Viola tricolor], kalanchoe [Kalanchoe blossfeldiana], and dandelion [Taraxacum officinale]) were subjected to freezing (in their natural form and in ice cubes) and analyzed in terms of visual appearance, the content of flavonoids, hydrolysable tannins, phenolics, antioxidant activity (2,2-diphenyl-1-picrylhydrazyl radical scavenging activity and reducing power), and microbial quality after storage for 1 and 3 months. Flowers in ice cubes showed similar appearance to fresh ones during the 3 months of storage, whereas frozen flowers were only equivalent up to 1 month with the exception of kalanchoe. Even though flowers in ice cubes showed good appearance after 3 months of storage, they had the lowest values of bioactive compounds and antioxidant activity. On the contrary, when frozen, the content of bioactive compounds maintained or even increased up to 1 month of storage compared to fresh flowers, except for borage. Furthermore, in both freezing treatments, the microorganisms' counts decreased or maintained when compared to fresh samples, except in dandelion. In general, both treatments may allow keeping the flowers after their flowering times. PRACTICAL APPLICATION: The market of edible flowers is increasing, although they are a very perishable product with short shelf-life. Edible flowers are stored in the cold (frozen or in ice cubes); however, the effect on the bioactive compounds and microbial quality that this treatment may have on borage (Borago officinalis), heartsease (Viola tricolor), kalanchoe (Kalanchoe blossfeldiana), and dandelion (Taraxacum officinale) flowers is unknown. So, the present study was conducted to increase the knowledge about the changes that freezing treatments may have in different edible flowers. The results of the present study underline that each flower has different behavior at frozen and ice cubes storage. However, freezing flowers maintain/increase the contents of bioactive compounds, while ice cubes not. Both treatments are effective in protecting flowers from microorganism growth. So, suggesting that both freezing treatments can be used as a preservative method and may allow keeping the flowers after their flowering times.

Effect of high-pressure processing on carotenoids profile, colour, microbial and enzymatic stability of cloudy carrot juice.

The objective of this work was to assess the impact of high-pressure processing (HPP) on the carotenoid profile, colour as well as the microbial and enzymatic stability of cloudy carrot juice. The predominant carotenoids in the fresh juices were by far the provitamin A carotenoids ß-carotene and α-carotene. Others were ζ-carotene, phytofluene, phytoene and lutein. HPP at 300 MPa in three cycles caused the highest carotenoids degradation (41%) whereas the lowest degradation (26%) was achieved at 600 MPa. The highest inactivation of POD (31%) and PPO (57%) was achieved with 600 MPa and 300 MPa applied in three cycles, respectively what indicates that POD is more responsible for carotenoids degradation. The colour differences (ΔE*ab) between fresh juice and HPP-treated juices ranged from 3.02 to 4.15 CIELAB units. As far as the impact on microorganism was concerned, there was a clear trend between the applied pressure and the microbial reduction achieved.

Physicochemical, antioxidant and microbial properties of crystallized pansies (Viola × wittrockiana) during storage.

Edible flowers, such as pansies, have a short shelf-life. Crystallization is a treatment used to prolong the shelf-life of fruits and vegetables. So, the aim of the present work was to investigate the effect of crystallization in the physicochemical, microbial and antioxidant properties of pansies (Viola×wittrockiana) during room temperature storage (7, 15, 30, 60 and 90 days). Comparing fresh and crystallized pansies, significant differences were detected. After 90 days of storage, crystallized pansies kept similar appearance to those immediately after treatment. A significant decrease in water activity, moisture, ash and protein contents was observed between 0 and 90 days of storage for crystallized pansies. Some bioactive compounds, such as flavonoids and monomeric anthocyanins, showed a significant decrease after 90 days of storage, while hydrolysable tannins increased. Concerning phenolic compounds, these maintained constant along storage. The microbial load of crystallized pansies during all storage time was lower than fresh ones. So, crystallization can be an effective method for pansies preservation, being some nutritional and bioactive compounds, little affected during storage. However, crystallization contributed to a high increase in sugar content and energy values compared to fresh pansies.

Nutritional and Nutraceutical Composition of Pansies (Viola × wittrockiana) During Flowering.

Edible flowers consumption and use are an increasing food trend worldwide, although information concerning their nutritional composition and nutraceutical value is still scarce. Thus, the aim of this study was to contribute to the popularization of pansies (Viola × wittrockiana), through the analysis of the nutritional and nutraceutical features of pansies with different colors (white, yellow, and red) and flowering stages. Both flower type and flowering stage influenced the flower composition. When completely open, white and yellow pansies had the highest contents of protein (>2.00 g/100 g fresh weight), while red pansies had the highest content of carbohydrates (8.0 g/100 g fresh weight). Regarding the fatty acid profiles, linoleic acid was always predominant (ranging between 18.7 and 51.0 g/100 g fatty acids), followed by the palmitic and linolenic acids. During flowering, there was an increase in protein, fat, and linolenic acid contents in white and yellow pansies, whereas in red pansies the values did not change. Red pansies were characterized by the highest contents of total carotenoids (873 to 1300 µg ß-carotene/g dry weight) and monomeric anthocyanins (303 to 402 µg Cy-3 glu/g dry weight); however, white and yellow pansies showed an increase in the values of total reducing capacity (total phenols), hydrolysable tannins, flavonoids, monomeric anthocyanins, and antioxidant activity from the bud to completely open flower stage. Our results underline the nutritional differences between pansies with different colors at distinct stages of development and their potential health benefits, suggesting that they can be used as ingredient to improve the nutritional properties of foods. PRACTICAL APPLICATION: The market of edible flowers is increasing, although little information in nutritional view is available. So, the present study was conducted to contribute to the popularization of edible flowers as a new and prospective source for the food industry, as well as a promising product for human nutrition. The results of the present study underline the nutritional differences between pansies with different colors at distinct stages of development and their potential health benefits, suggesting that they can be used as ingredient to improve the nutritional properties of foods.

Enhancement of Bioactivity of Natural Extracts by Non-Thermal High Hydrostatic Pressure Extraction.

Natural extracts, like those obtained from medicinal herbs, dietary plants and fruits are being recognized as important sources of bioactive compounds with several functionalities including antioxidant, anticancer, and antimicrobial activities. Plant extracts rich in phenolic antioxidants are currently being successfully used for several pharmaceutical applications and in the development of new foods (i.e., functional foods), in order to enhance the bioactivity of the products and to replace synthetic antioxidants. The extraction method applied in the recovery of the bioactive compounds from natural materials is a key factor to enhance the bioactivity of the extracts. However, most of the extraction techniques have to employ heat, which can easily lead to heat-sensitive compounds losing their biological activity, due to changes caused by temperature. Presently, high hydrostatic pressure (HHP) is being increasingly explored as a cold extraction method of bioactive compounds from natural sources. This non-thermal high hydrostatic pressure extraction (HHPE) technique allows one to reduce the extraction time and increase the extraction of natural beneficial ingredients, in terms of nutritional value and biological activities and thus enhance the bioactivity of the extracts. This review provides an updated and comprehensive overview on the extraction efficiency of HHPE for the production of natural extracts with enhanced bioactivity, based on the extraction yield, total content and individual composition of bioactive compounds, extraction selectivity, and biological activities of the different plant extracts, so far studied by extraction with this technique.

Long-Term Effect on Bioactive Components and Antioxidant Activity of Thermal and High-Pressure Pasteurization of Orange Juice.

The long-term effect of thermal pasteurization (TP) and high-pressure processing (HPP) of orange juices stored under refrigeration, on the bioactive components and antioxidant activity, was compared. Total phenolic content (TPC), flavonoid, anthocyanin, and carotenoid contents, the individual content of major phenolic components, and the antioxidant activity, were evaluated in TP- and HPP-treated juices over a 36-day period. At day 0, no significant differences in TPC, and a decrease in carotenoid content after both treatments, were observed. TP caused a decrease of flavonoid and anthocyanin contents, while HPP increased flavonoid content. Three major phenolic components were identified: apigenin-6,8-di-C-glucoside, naringenin-7-O-rutinoside, and hesperetin-7-O-rutinoside, the latter increasing ca. 45% immediately after HPP. During storage, a decrease in TPC, and in the anthocyanin and carotenoid contents of both treated juices was observed, with higher anthocyanin and phenolic contents in HPP juices. A significant increase of hesperetin-7-O-rutinoside content was observed in HPP juice. Both treatments caused a decrease (26% and 13%, respectively) of antioxidant activity. Most of the kinetic profiles followed zero-order patterns, with HPP juices showing a considerably higher half-life than TP ones. These results clearly demonstrate the advantages of HPP for orange juice preservation allowing, also, their nutritional benefits to be enhanced by increasing the content of some bioactive components.

Optimization of ultrasound-assisted extraction of phenolic compounds from grapefruit (Citrus paradisi Macf.) leaves via D-optimal design and artificial neural network design with categorical and quantitative variables.

BACKGROUND: The extraction of phenolic compounds from grapefruit leaves assisted by ultrasound-assisted extraction (UAE) was optimized using response surface methodology (RSM) by means of D-optimal experimental design and artificial neural network (ANN). For this purpose, five numerical factors were selected: ethanol concentration (0-50%), extraction time (15-60 min), extraction temperature (25-50 °C), solid:liquid ratio (50-100 g L-1 ) and calorimetric energy density of ultrasound (0.25-0.50 kW L-1 ), whereas ultrasound probe horn diameter (13 or 19 mm) was chosen as categorical factor. RESULTS: The optimized experimental conditions yielded by RSM were: 10.80% for ethanol concentration; 58.52 min for extraction time; 30.37 °C for extraction temperature; 52.33 g L-1 for solid:liquid ratio; 0.457 kW L-1 for ultrasonic power density, with thick probe type. Under these conditions total phenolics content was found to be 19.04 mg gallic acid equivalents g-1 dried leaf. CONCLUSION: The same dataset was used to train multilayer feed-forward networks using different approaches via MATLAB, with ANN exhibiting superior performance to RSM (differences included categorical factor in one model and higher regression coefficients), while close values were obtained for the extraction variables under study, except for ethanol concentration and extraction time. © 2018 Society of Chemical Industry.

Impact of different hyperbaric storage conditions on microbial, physicochemical and enzymatic parameters of watermelon juice.

Hyperbaric storage (HS) of raw watermelon juice, up to 10days at 50, 75, and 100MPa at variable/uncontrolled room temperature (18-23°C, RT) was studied and compared with storage at atmospheric pressure (AP) under refrigeration (4°C, RF) and RT, being evaluated microbiological (endogenous and inoculated), physicochemical parameters, and enzymatic activities. Ten days of storage at 50MPa resulted in a microbial growth evolution similar to RF, while at 75/100MPa were observed microbial load reductions on endogenous and inoculated microorganisms (Escherichia coli and Listeria innocua, whose counts were reduced to below the detection limit of 1.00 log CFU/mL), resulting in a shelf-life extension compared to RF. The physicochemical parameters remained stable at 75MPa when compared to the initial raw juice, except for browning degree that increased 1.72-fold, whilst at 100MPa were observed higher colour variations, attributed to a lycopene content decrease (25%), as well as reductions on peroxidase residual activity (16.8%) after 10days, while both polyphenol oxidase and pectin methylesterase residual activities were similar to RF. These outcomes hint HS as a reliable alternative to RF as a new food preservation methodology, allowing energy savings and shelf-life extension of food products. This is the first paper studying the effect of HS on inoculated microorganisms and on a broad number of physicochemical parameters and on endogenous enzymatic activities, for a preservation length surpassing the shelf-life by RF.

Simulação Médica no Ensino Universitário de Pediatria / Medical Simulation in the University Teaching of Pediatrics

RESUMO Objetivos Demonstrar as vantagens do uso de manequins simuladores no ensino prático médico, em particular pediátrico, e estudar os diferentes tipos de manequins/modelos existentes, especificidades e utilização própria de cada um deles. Métodos A formação médica baseada na transmissão teórica de conhecimentos e com aprendizagem clínica praticada em doentes reais não é viável atualmente, pois depende da oportunidade e disponibilidade dos doentes em determinado momento. Hoje em dia, a Medicina recorre a modelos de simulação médica, permitindo o desenvolvimento da proficiência necessária à execução de determinado procedimento. A simulação médica proporciona diversas vantagens: não requer doentes reais e disponíveis, possibilita repetição da técnica com correção de erros, aumenta o nível de confiança do aluno em suas capacidades e não oferece risco ao doente. Desde 2009, o ensino de Pediatria no Estágio de Saúde Infantil dos alunos do sexto ano do Mestrado Integrado em Medicina na Faculdade de Medicina de Coimbra contempla aulas práticas com modelos, onde os alunos treinam técnicas como: intubação pediátrica, manobra de Ortolani, punção venosa em membros superiores, punção lombar, intubação orotraqueal, auscultação do murmúrio vesicular, punção venosa, avaliação da fontanela normotensa e da hipertensão da fontanela. Esta componente prática de ensino estimula e agrada aos alunos, que todos os anos a elegem como uma das preferidas do Estágio de Saúde Infantil no âmbito do Mestrado Integrado. Resultados Aquisição de conhecimentos e prática de técnicas médicas, invasivas e não invasivas, por parte dos alunos, recorrendo a modelos de simulação médica pediátricos, nomeadamente: intubação pediátrica, manobra de Ortolani, punção venosa em membros superiores, punção lombar, intubação orotraqueal, auscultação do murmúrio vesicular, punção venosa, avaliação da fontanela normotensa e da hipertensão da fontanela. Feita a avaliação destas mesmas aulas pelos alunos por meio de questionário de preferências, ficou claro que esta é uma das aulas preferidas dos alunos do sexto ano de Medicina em Estágio de Saúde Infantil do Mestrado Integrado em Medicina. Conclusões Foi possível aos alunos desenvolver competências na realização de procedimentos médicos, com uma avaliação muito positiva pelos estudantes do Estágio em Saúde Infantil do Mestrado Integrado em Medicina.

ABSTRACT Objectives To demonstrate the advantages of using simulator mannequins in practical medical education and particularly in pediatrics, studying the different kinds of existing mannequins/models, their specific characteristics and uses. Methods Medical training based on the theoretical transmission of knowledge and clinical learning practiced on real patients is currently unviable because it is dependent on the timing and availability of patients at any given moment. Nowadays, medicine uses medical simulation models, thus facilitating the development of proficiency in skills required for the execution of particular procedures. Medical simulation provides several advantages: it does not require real and available patients, techniques may be repeated in order to address errors, students’ confidence in their abilities is promoted, and there is an absence of risk for the patient. Since 2009, the child health internship undertaken as part of the pediatric education section of the Integrated Master’s degree at the University of Coimbra Faculty of Medicine by sixth-year students has included practical classes with models where students practice techniques such as pediatric intubation, the Ortolani maneuver, venipuncture in upper limbs, lumbar puncture, endotracheal intubation, breath sounds auscultation, venipuncture, evaluation of normotensive fontanelle, and hypertension fontanelle. This practical component stimulates and appeals to students, who repeatedly select these classes as one of their favorites on the child health internship completed as part of the Integrated Master’s degree in Medicine. Results Students used medical simulation models to acquire knowledge and practice medical, invasive and non-invasive techniques such as: pediatric intubation, the Ortolani maneuver, venipuncture in the upper limbs, lumbar puncture, endotracheal intubation, breath sounds auscultation, venipuncture, evaluation of normotensive fontanelle, and hypertension fontanelle. Upon the students’ assessment by means of a preference questionnaire, it became clear that these classes were some of those preferred by sixth-year students completing the child health internship as part of their Integrated Master’s degree. Conclusions Students completing child health internships as part of the Integrated Master’s degree in medicine were able to develop skills in performing medical procedures, with very positive assessments given by these students on the experience.

Eating behaviors, body image, perfectionism, and self-esteem in a sample of Portuguese girls

Objective: Eating disorders are an increasingly prevalent health problem among adolescent girls. It is well known that biological, psychosocial, and family-related factors interact in the development of this group of disorders. However, the mechanisms underlying the interaction between these variables are still poorly understood, especially in Portuguese adolescents. The aim of this study was to investigate the relationship between eating behaviors, body dissatisfaction, self-esteem, and perfectionism in a sample of Portuguese girls. Method: A community sample of 575 Portuguese girls attending secondary school, answered self-report questionnaires including data on weight, height, and the Portuguese versions of the Contour Figures Rating Scale, the Child and Adolescent Perfectionism Scale, the Children Eating Attitudes Test, and the Rosenberg Self-Esteem Scale. SPSS version 20.0 for Windows was used for statistical analyses. Results: High scores in the Children Eating Attitudes Test were associated with significantly higher levels of body dissatisfaction (r = 0.339), socially prescribed perfectionism (r = 0.175), self-oriented perfectionism (r = 0.211), and low self-esteem (r = -0.292) (all p < 0.001). Self-oriented perfectionism partially mediated the relation between body dissatisfaction and disordered eating behaviors. Conclusion: In this sample, dysfunctional eating behaviors appeared to correlate strongly with body dissatisfaction, low self-esteem, and perfectionism in girls. These themes should be addressed among female adolescents in the community.