Lupin as Ingredient in Durum Wheat Breadmaking: Physicochemical Properties of Flour Blends and Bread Quality.

The popularity of adding pulse flours to baked goods is growing rapidly due to their recognised health benefits. In this study, increasing amounts (3, 7, 10, and 15%) of white lupin flour (Lupinus albus L.) and of protein concentrate from narrow-leaved lupin (Lupinus angustifolius L.) were used as replacements for durum wheat semolina to prepare bread, and their effects on the physicochemical properties of the flour blends, as well as the technological and sensory qualities of bread, were evaluated. The addition of protein concentrate from narrow-leaved lupin and white lupin flour increased the water binding capacity and the leavening rate compared to pure semolina. A farinograph test indicated that the dough development time had a slight but significant tendency to increase with the addition of lupin flour and protein concentrate of narrow-leaved lupin, while had a negative effect on the stability of dough. The alveograph strength decreased (225, 108, and 76 × 10-4 J for dough made with semolina, 15% of protein concentrate from narrow-leaved lupin, and 15% of white lupin flour, respectively), whereas there was an upward trend in the P/L ratio. Compared to re-milled semolina, the samples with lupin flour and protein concentrate from narrow-leaved lupin had low amylase activity, with falling number values ranging from 439 s to 566 s. The addition of the two different lupin flours lowered the specific volumes of the breads (2.85, 2.39, and 1.93 cm3/g for bread made from semolina, from 15% of protein concentrate from narrow-leaved lupin, and from 15% of white lupin flour, respectively) and increased their hardness values (up to 21.34 N in the bread with 15% of protein concentrate from narrow-leaved lupin). The porosity of the loaves was diminished with the addition of the two lupin flours (range of 5-8). The sensory analysis showed that the addition of white lupin flour or protein concentrate from narrow-leaved lupin did not impart any unpleasant flavours or odours to the bread. To conclude, the use of lupin in breadmaking requires adjustments to strengthen the gluten network but does not require a deflavouring process.

Artichoke Industrial Waste in Durum Wheat Bread: Effects of Two Different Preparation and Drying Methods of Flours and Evaluation of Quality Parameters during Short Storage.

'Violetto di Ramacca' is a local variety of artichoke grown in Sicily (Southern Italy), known for its purple color with green streaks. In this study, the effects of two different preparation and drying methods (method A, fresh sample oven-dried at 40 °C for 48 h then mixed and ground into flour; and B, minced and frozen sample oven-dried at 40 °C for 24 h then blended and ground into flour) for flours from different parts of the artichoke (bracts, stems, and mix), used at different percentages of integration (5, 7.5, and 10%), in combination with re-milled semolina, have been evaluated. The polyphenol contents of the flours produced with the two methods were measured. The results showed significant differences between the methods and samples, with a range from 9.09 mg GAE/g d.m. (bracts 100%, method A) to 2.62 mg/g (mix 100%, method B). The values were then lowered in the flour products with supplements ranging from 0.96 mg GAE/g (bract flour 10%, method A) to 0.11 mg GAE/g (mixed flour 7.5%, method B). As the amounts of polyphenols increased, the antioxidant activity increased, with a range that varied in the pure flour from 8.59 mg trolox eq/g d.m. (bract flour, method A) to 3.83 mg trolox eq/g d.m. (mixed flour, method B). These flours were also analyzed for color, highlighting a clear difference between methods A (greener) and B (browner). The flours thus obtained were used to produce breads, which were evaluated for their physicochemical characteristics during 4 days of storage. The results showed a reduction in volumes and heights, an increase in the percentage of integration of the artichoke flours, a greater quantity of moisture in the integrated breads, and a lower reduction in the structural characteristics during storage compared to the control breads. The TPA was conducted on the breads from T0 to T4, highlighting that, although initially more compact, the integrated breads offered less alteration of the values during storage. The aw ranged from 0.63 (mix flour 5%, method B) to 0.90 (bract flour 5%, method B). The amounts of polyphenols (from 0.57 mg GAE/g in bread with bracts at 10% (method A) to 0.13 mg GAE/g in bread with mix 5% (method B)) and the antioxidant activity (from 0.55 mg trolox eq/g d.m. in bread with bract flour 10% (method A) to 0.14% mg trolox eq/g d.m. in bread with mix flour) were also evaluated, showing a trend similar to the values obtained in the flours. Colorimetric tests highlighted a color more similar to wholemeal bread in the loaves produced with method B. Statistical factor analysis and cluster analysis were conducted for all trials.

Toward appropriate criteria in medication adherence assessment in older persons: Position Paper.

Nonadherence to medication regimens is a worldwide challenge; adherence rates range from 38 to 57 % in older populations with an average rate of less than 45 % and nonadherence contributes to adverse drug events, increased emergency visits and hospitalisations. Accurate measurement of medication adherence is important in terms of both research and clinical practice. However, the identification of an objective approach to measure nonadherence is still an ongoing challenge. The aim of this Position Paper is to describe the advantages and disadvantages of the known medication adherence tools (self-report, pill count, medication event monitoring system (MEMS) and electronic monitoring devices, therapeutic drug monitoring, pharmacy records based on pharmacy refill and pharmacy claims databases) to provide the appropriate criteria to assess medication adherence in older persons. To the best of our knowledge, no gold standard has been identified in adherence measurement and no single method is sufficiently reliable and accurate. A combination of methods appears to be the most suitable. Secondly, adherence assessment should always consider tools enabling polypharmacy adherence assessment. Moreover, it is increasingly evident that adherence, as a process, has to be assessed over time and not just at one evaluation time point (drug discontinuation). When cognitive deficits or functional impairments may impair reliability of adherence assessment, a comprehensive geriatric assessment should be performed and the caregiver involved. Finally, studies considering the possible implementation in clinical practice of adherence assessment tools validated in research are needed.

Acute serous macular detachment and edema after uncomplicated phacoemulsification: A case series.

OBJECTIVE: To report cases of acute serous macular detachment and edema after uncomplicated phacoemulsification. DESIGN: Retrospective case series. PARTICIPANTS: We reviewed the clinical data of 5 patients who developed an acute serous macular detachment and edema after uncomplicated phacoemulsification with intraocular lens implantation by the same expert surgeon and without any complication during surgery. METHODS: Best corrected visual acuity (BCVA), biomicroscopy, fundus examination, and optical coherence tomography were performed at 1, 3, 7, and 30 postoperative days. RESULTS: On the first postoperative day, all eyes had low visual acuity (median 1.0 logMAR) despite normal postoperative appearance of the anterior segment. Optical coherence tomography showed serous macular detachment with intraretinal fluid accumulation. After treatment with oral indomethacin and acetazolamide, at 7 days, intraretinal and subretinal fluid were fully reabsorbed and BCVA improved (at least 0.1 logMAR). In the following 6 months, no eye had recurrence of macular edema. CONCLUSIONS: Acute serous macular detachment and edema can occur after uncomplicated phacoemulsification. It should be considered in cases of low visual acuity during the early postoperative period.