Valorization of kiwi agricultural waste and industry by-products by recovering bioactive compounds and applications as food additives: A circular economy model.

Currently, agricultural production generates large amounts of organic waste, both from the maintenance of farms and crops (agricultural wastes) and from the industrialization of the product (food industry waste). In the case of Actinidia cultivation, agricultural waste groups together leaves, flowers, stems and roots while food industry by-products are represented by discarded fruits, skin and seeds. All these matrices are now underexploited and so, they can be revalued as a natural source of ingredients to be applied in food, cosmetic or pharmaceutical industries. Kiwifruit composition (phenolic compounds, volatile compounds, vitamins, minerals, dietary fiber, etc.) is an outstanding basis, especially for its high content in vitamin C and phenolic compounds. These compounds possess antioxidant, anti-inflammatory or antimicrobial activities, among other beneficial properties for health, but stand out for their digestive enhancement and prebiotic role. Although the biological properties of kiwi fruit have been analyzed, few studies show the high content of compounds with biological functions present in these by-products. Therefore, agricultural and food industry wastes derived from processing kiwi are regarded as useful matrices for the development of innovative applications in the food (pectins, softeners, milk coagulants, and colorants), cosmetic (ecological pigments) and pharmaceutical industry (fortified, functional, nutraceutical, or prebiotic foods). This strategy will provide economic and environmental benefits, turning this industry into a sustainable and environmentally friendly production system, promoting a circular and sustainable economy.

Culinary and nutritional value of edible wild plants from northern Spain rich in phenolic compounds with potential health benefits.

Wild edible plants (WEPs) have been consumed since ancient times. They are considered as non-domesticated plants that grow spontaneously in nature, particularly in forests and bushlands, where they can be found and collected to be incorporated into human nutrition. Increasingly, WEPs are gaining importance as they are potential sources of food due to their nutritional value, besides showing positive health effects and offer innovative applications in haute cuisine. As these autochthonous plants grow naturally in the environment, they are more suitable to adapt to different climatic conditions as well as biotic and abiotic factors. Therefore, a door has been opened for their possible cultivation as they seem to require fewer expenses than other commercially cultivated plants. Moreover, the consumers demand for new products of natural origin that are sustainable and ecologically labeled have also boosted WEPs' recovery and incorporation into the market. In addition, they are considered as promising sources of essential compounds needed not only in human diet including carbohydrates, proteins, and lipids but also of other minor compounds as phenols, vitamins, or carotenoids that have shown numerous beneficial bioactivities such as antioxidants, anti-inflammatory, or anti-tumor activity. The use of these plants rich in bioactive molecules could be beneficial from the health point of view as the human body is not always capable of producing enough defenses, for instance, preventing oxidative damage. In particular, the presence of phenolic compounds in these vegetal matrices is supposed to provide a prophylactic effect against further pathogenesis and disorders related to aging or oxidative stresses. Regarding all this information based on traditional knowledge and ethnobotanical data, different WEPs found in the Northwestern region of Spain were selected, namely, Mentha suaveolens, Glechoma hederacea, Prunus spinosa, Apium nodiflorum, Artemisia absinthium, Silybum marianum, Picris hieracioides, Portulaca oleracea, Crithmum maritimum, and the genus Amaranthus. However, even though tradition and popular knowledge are excellent tools for the exploitation of these plants, it is necessary to develop regulations in this aspect to assure safety and veracity of food products. This article aims to review the main aspects of their bioactive properties, their traditional use, and the possibility of their incorporation into the market as new functional foods, looking at innovative and healthy gastronomic applications.

Stability assessment of extracts obtained from Arbutus unedo L. fruits in powder and solution systems using machine-learning methodologies.

Arbutus unedo L. (strawberry tree) has showed considerable content in phenolic compounds, especially flavan-3-ols (catechin, gallocatechin, among others). The interest of flavan-3-ols has increased due their bioactive actions, namely antioxidant and antimicrobial activities, and by association of their consumption to diverse health benefits including the prevention of obesity, cardiovascular diseases or cancer. These compounds, mainly catechin, have been showed potential for use as natural preservative in foodstuffs; however, their degradation is increased by pH and temperature of processing and storage, which can limit their use by food industry. To model the degradation kinetics of these compounds under different conditions of storage, three kinds of machine learning models were developed: i) random forest, ii) support vector machine and iii) artificial neural network. The selected models can be used to track the kinetics of the different compounds and properties under study without the prior knowledge requirement of the reaction system.

Scientific basis for the industrialization of traditionally used plants of the Rosaceae family.

Plants have been traditionally used for the treatment of different types of illness, due to biomolecules with recognised benefits. Rosaceae family is used in traditional Galician medicine. The following plants Agrimonia eupatoria, Crataegus monogyna, Filipendula ulmaria, Geum urbanum, Potentilla erecta and Rosa canina are usually found in treatments. The aim of this study is to perform an ethnobotanical review about the bioactive compounds of these plants and their different bioactivities, both studied in vitro and in vivo. The nature of the bioactive compounds is varied, highlighting the presence of different phenolic compounds, such as phenolic acids, flavonoids or tannins. Understanding the beneficial effects of the administration of the whole plant or target tissues from A. eupatoria, C. monogyna, F. ulmaria, G. urbanum, P. erecta and R. canina as well as those from their individual compounds could lead to the development of new drugs based on the use of natural ingredients.

Ultrasound as a Rapid and Low-Cost Extraction Procedure to Obtain Anthocyanin-Based Colorants from Prunus spinosa L. Fruit Epicarp: Comparative Study with Conventional Heat-Based Extraction.

An ultrasound rapid and low-cost procedure for anthocyanin-based colorants from Prunus spinosa L. fruit epicarp was developed, and the advantages were compared with conventional heat-based extraction. To obtain the conditions that maximize anthocyanins' extraction, a response surface methodology was applied using the variables of time, temperature, and ethanol content, in the case of heat extraction, whereas for ultrasound assisted extraction, temperature was replaced by ultrasound power. Two anthocyanin compounds were identified by HPLC-DAD-ESI/MS-namely, cyanidin 3-rutinoside and peonidin 3-rutinoside. The responses used were the extraction yield and the content of the identified anthocyanins. Ultrasound extraction was the most effective method at 5.00 ± 0.15 min, 400.00 ± 32.00 W, and 47.98% ± 2.88% of ethanol obtaining 68.60% ± 2.06% of extracted residue, with an anthocyanin content of 18.17 mg/g (extract-basis) and 11.76 mg/g (epicarp-basis). Overall, a viable green process was achieved that could be used to support pilot-scale studies for industrial production of anthocyanin-based colorants from P. spinosa fruit epicarp.

Description of patients excluded for Mohs surgery after pre-surgical evaluation: data from the Regesmohs Spanish registry. / Descripción de pacientes no aptos para ser sometidos a cirugía de Mohs tras valoración prequirúrgica: datos del registro español Regesmohs.

BACKGROUND: Regesmohs registry is a nationwide registry including patients evaluated for Mohs surgery in 17 Spanish centres since July 2013. Given that Mohs surgery is the therapy with best results for high risk basal cell carcinoma (BCC) and other skin tumours, we wanted to describe the reasons that lead to some patients being excluded from this therapy and the alternative treatments that they received. These data may be useful to avoid excluding patients for Mohs surgery use, to estimate the healthcare demand of these patients and the demand for Hedgehog inhibitors therapy in this group. OBJECTIVE: To describe patients excluded for Mohs surgery after pre-surgical assessment, and the treatments that they received. METHODS: Regesmohs includes all consecutive patients assessed for Mohs surgery in the participating centres, collecting data on patient characteristics, intervention, and short and long-term results. Patients excluded for Mohs surgery after pre-surgical evaluation were described. RESULTS: 3011 patients were included in Regesmohs from July 2013 to October 2016. In 85, Mohs surgery was not performed as they were considered inadequate candidates. 67 had BCC. Reasons for exclusion were: medical contraindication (27.1%, n=23) low-risk tumour in (18.8%, n=16) and giant tumour and bone invasion (15.3%, n=13). Only 1 patient (1.2%) showed lymph node involvement and no patients had visceral metastases. Of the 85 excluded patients, 29 (34.1%) were treated with conventional surgery, 24 (28.3%) with radiotherapy, 4 (4.7%) with inhibitors of the Hedgehog pathway (only indicated for BCC), and 2 (2.4%) received palliative care. We had no follow-up data on 14 patients (16.5%). CONCLUSION: Medical comorbidities were the most common reason for withholding Mohs surgery. Withholding therapy on the basis of distant extension is uncommon. Most excluded patients received simpler therapies: conventional surgery or radiotherapy, with hedgehog inhibitors being a new option.

Mathematical models of cytotoxic effects in endpoint tumor cell line assays: critical assessment of the application of a single parametric value as a standard criterion to quantify the dose-response effects and new unexplored proposal formats.

The development of convenient tools for describing and quantifying the effects of standard and novel therapeutic agents is essential for the research community, to perform more precise evaluations. Although mathematical models and quantification criteria have been exchanged in the last decade between different fields of study, there are relevant methodologies that lack proper mathematical descriptions and standard criteria to quantify their responses. Therefore, part of the relevant information that can be drawn from the experimental results obtained and the quantification of its statistical reliability are lost. Despite its relevance, there is not a standard form for the in vitro endpoint tumor cell lines' assays (TCLA) that enables the evaluation of the cytotoxic dose-response effects of anti-tumor drugs. The analysis of all the specific problems associated with the diverse nature of the available TCLA used is unfeasible. However, since most TCLA share the main objectives and similar operative requirements, we have chosen the sulforhodamine B (SRB) colorimetric assay for cytotoxicity screening of tumor cell lines as an experimental case study. In this work, the common biological and practical non-linear dose-response mathematical models are tested against experimental data and, following several statistical analyses, the model based on the Weibull distribution was confirmed as the convenient approximation to test the cytotoxic effectiveness of anti-tumor compounds. Then, the advantages and disadvantages of all the different parametric criteria derived from the model, which enable the quantification of the dose-response drug-effects, are extensively discussed. Therefore, model and standard criteria for easily performing the comparisons between different compounds are established. The advantages include a simple application, provision of parametric estimations that characterize the response as standard criteria, economization of experimental effort and enabling rigorous comparisons among the effects of different compounds and experimental approaches. In all experimental data fitted, the calculated parameters were always statistically significant, the equations proved to be consistent and the correlation coefficient of determination was, in most of the cases, higher than 0.98.

Characterization of Surgical Procedures in the Spanish Mohs Surgery Registry (REGESMOHS) for 2013-2015. / Descripción de las intervenciones quirúrgicas recogidas en el registro español de cirugía de Mohs (REGESMOHS) (2013-2015).

INTRODUCTION: The Spanish Mohs Surgery Registry is used to collect data on the use and outcomes of Mohs micrographic surgery (MMS) in Spain. The aim of this study was to describe perioperative and intraoperative data recorded for MMS procedures performed between July 2013 (when the registry started) and January 2016. MATERIAL AND METHODS: Prospective cohort study of data from 18 hospitals. The data collected included type of anesthesia, surgical technique, hospital admission, number of Mohs stages, management of preoperative risk factors, additional treatments, previous treatments, type of tumor, operating time, and complications. RESULTS: Data were available for 1796 operations. The most common tumor treated by MMS was basal cell carcinoma (85.96%), followed by squamous cell carcinoma (6.18%), lentigo maligna (2.81%), and dermatofibrosarcoma protuberans (1.97%). Primary tumors accounted for 66.9% of all tumors operated on; 19.2% of tumors were recurrent and 13.9% were persistent. The most common previous treatment was surgical. MMS was mostly performed under local anesthesia (86.7% of cases) and as an outpatient procedure (71.8%). The frozen section technique was used in 89.5% of cases. One stage was needed to achieve tumor-free margins in 56.45% of patients; 2 stages were required in 32.1% of patients, 3 in 7.1%%, 4 in 2.7%, and 5 or more in 1.8%. The defect was reconstructed by the dermatologist in 98% of patients and the most common technique was flap closure (47.2%). Intraoperative complications were recorded for just 1.62% of patients and the median (interquartile range) duration of surgery was 75 (60-100) minutes. CONCLUSION: The characteristics of the patients and tumors treated by MMS are similar to those reported for similar studies in other geographic areas. Lentigo maligna and dermatofibrosarcoma protuberans accounted for a higher proportion of cases in our series, and repair of the surgical defect by a dermatologist was also more common. Operating times in MMS are not much longer than those reported for other procedures and the rate of intraoperative complications is very low.

Mathematical modeling of area under the curve assessment criteria to quantify the antioxidant and pro-oxidant capacity: Coffee extracts as a case study.

The development of a convenient mathematical application for testing the antioxidant and pro-oxidant capacity is essential in order to investigate potential sources of new agents and processes. In this regard, authors use the standardized values of the area under the curve of a kinetic profile of a dose-response agent, as a way to bypass the complex process of analyzing the kinetic variations of agents. In general, linear approaches are used, but such patterns frequently lead to unreliable results and misinterpretations, making it extremely difficult to compare the results from different assays. In this work, we have demonstrated the non-linearity of the dose-response area under the curve assessment criteria by means of simulations. A simple non-linear dose-response model was developed to describe the accurate response. As a case study, experimental data of extracts of unroasted coffee beans from five different country-climate locations for the two most common coffee varieties (Robusta and Arabica) were obtained using the ß-carotene and crocin bleaching in vitro assays. Their antioxidant capacity was analyzed in detail and compared with commercial standards. The results show that the antioxidant capacity was greater than some of the commercial standards in terms of its maximum capacity, while when the analyses are based on rate parameters, the coffee extracts show between 6 and 40 times lower values than the standard antioxidants. In addition, to illustrate the advantages of using the standardized area units and the mathematical model developed, other more complex scenarios were recreated. We believe that the model application developed provides a simple alternative to summarize meaningful parameters that characterize the response, facilitates rigorous comparisons among the effects of different compounds and experimental approaches and helps to comprehend multi-variable scenarios.

Prophylactic vitamin D in healthy infants: assessing the need.

The objective was to evaluate the need for vitamin D prophylaxis in healthy infants. This was a prospective and randomized study performed at primary care clinics. Eighty-eight full-term 1-month-old healthy infants were randomly assigned to receive (n = 41) or not (n = 47) 402 IU/d of vitamin D for 1 year. Primary outcome measures were serum 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) concentrations at 3, 6, and 12 months of age; secondary measures included data on feeding, habitat, season of birth, sun exposure, and physical examination. At 3 and 6 months of age, serum 25OHD levels (±SD) were significantly higher (P < .001) in the prophylaxis group. In the group without prophylaxis, serum 25OHD increased with age; and breast-fed infants aged 3 months had the lowest value (20.2 ± 9.4 ng/mL), which was significantly (P = .001) lower than that of formula-fed infants (35.0 ± 9.7 ng/mL). The PTH levels were not influenced by the prophylaxis or feeding. No influence of either the habitat or season of birth on serum 25OHD concentrations was demonstrated. No infant had clinical signs of vitamin D deficiency. Serum 25OHD and PTH concentrations were weakly but significantly correlated (r = -0.29, P = .009) at 3 months of age. Healthy infants without vitamin D prophylaxis had lower circulating concentrations of 25OHD at 3 and 6 months of age, the lowest value being found in 3-month breast-fed infants. The clinical relevance of these findings is probably negligible because serum 25OHD levels spontaneously increased with age and were not associated with high serum PTH. Clinical manifestations of rickets were not observed.

[Problems and proposals for improvement in the health care of economic immigrants]. / Problemas y propuestas de mejora en la atención sanitaria a los inmigrantes económicos.

OBJECTIVES: To analyse existing problems in health care to economic immigrants from the point of view of health and social professionals, health authorities and economic immigrants and to know which will be their proposals and priorities to improve economic immigrants's health assistance. METHODS: Qualitative approach study made in Majorca island. (Spain). Three focus groups and three nominal groups with health and social workers from primary health care and hospital services were carried out as well as two partially structured interviews to health authorities, one Autonomic Authority and one Governmental Authority, and twelve partially structured interviews to economic immigrants identified trough key informants. RESULTS: Health and social workers perceive the increase in the number of economic immigrants as a massive arrival. The main problems identified are: access restrictions to public health services for economic immigrants, the follow-up of these patients and diagnostic difficulties because lack of training in tropical medicine. Health and social workers's first proposal for improving this situation is their own training in tropical medicine. Autonomic Authority priorities are to guarantee access to public health services for all immigrants and to look actively for health problems in these population. Governmental Authority, instead, holds the legalization for all. In fact, economic immigrants are not concerned on health care because legalization and housing problems. CONCLUSIONS: The main barriers identified by health and social workers in health care to economic immigrants are: access restrictions, follow-up and lack of training in tropical medicine. Health and social first proposal to improve this situation is their own training in tropical medicine while Autonomic and Central Authorities's priorities are not the same. For economic immigrants, health assistance is not their biggest concern.

[Professionals and managers in face of training]. / Profesionales y gestores ante la formación.

OBJECTIVES: To analyse ongoing education within primary care teams from managers' perspective. DESIGN: Cross-sectional descriptive study. SETTING: The Mother-Infant Health Programme of Andalusia in primary care. INTERVENTION: The views of health centre professionals were obtained through 8 groups. The type of health district and the number of years in operation were used as criteria for division. The views of the area managers were collected through a self-filled questionnaire from all the managers in the autonomous community. MEASUREMENTS AND MAIN RESULTS: Professionals believed it necessary to keep up to date and train in new technology. They thought that training activities should focus on questions such as evaluation of programmes, focus of risk, counselling and communication, and certain techniques such as IUD insertion. Both managers and professionals coincided in recognising the effect of training on the development of mother-child services. There was consensus among professionals in affirming that training increases the quality of care delivered. Access to training was the main incentive element used by most area managers and one of those most highly valued by professionals. The professionals affirmed that in recent years there had been obstacles to their education by attending scientific events outside their areas. Many professionals stated that the economic assistance of the pharmaceutical industry for courses caused inequalities between doctors and nurses in access to training. Professionals were very critical of training combined with specialist training. CONCLUSIONS: Professionals think they have sufficient training for mother-child health care. It is generally recognised that family doctors are better trained for working on health programmes than other professionals at the centres. Ongoing training was rated very highly by both professionals and directors, as it was seen as a motivating element and thought to be an activity almost solely carried out at health centres.