Supercritical CO2 Treatment to Modify Techno-Functional Properties of Proteins Extracted from Tomato Seeds.

Tomato seeds are a rich source of protein that can be utilized for various industrial food purposes. This study delves into the effects of using supercritical CO2 (scCO2) on the structure and techno-functional properties of proteins extracted from defatted tomato seeds. The defatted meal was obtained using hexane (TSMH) and scCO2 (TSMC), and proteins were extracted using water (PEWH and PEWC) and saline solution (PESH and PESC). The results showed that scCO2 treatment significantly improved the techno-functional properties of protein extracts, such as oil-holding capacity and foaming capacity (especially for PEWC). Moreover, emulsifying capacity and stability were enhanced for PEWC and PESC, ranging between 4.8 and 46.7% and 11.3 and 96.3%, respectively. This was made possible by the changes in helix structure content induced by scCO2 treatment, which increased for PEWC (5.2%) and decreased for PESC (8.0%). Additionally, 2D electrophoresis revealed that scCO2 hydrolyzed alkaline proteins in the extracts. These findings demonstrate the potential of scCO2 treatment in producing modified proteins for food applications.

How are we handling protein drugs in hospitals? A human factors and systems engineering approach to compare two hospitals and suggest a best practice.

Biopharmaceuticals are complex biological molecules that require careful storage and handling to ensure medication integrity. In this study, a work system analysis of real-world protein drug (PD) handling was performed with the following goals: identify main barriers and facilitators for successful adherence to accepted recommendations in PD handling, analyse differences in two organizations, and define a Best Current Practice in the real-life handling of PDs based on the results of the work system analysis. Observational study was held in two university hospitals in Spain and Sweden. Based on the Systems Engineering Initiative for Patient Safety (SEIPS) model, the tools chosen were: the PETT scan, in order to indicate the presence of barriers or facilitators for the PETT components (People, Environment, Tools, Tasks); the Tasks and tools matrices to construct a checklist to record direct observations during the real-life handling of biopharmaceuticals, and the Journey map to depict the work process. Observations were performed between March and November 2022. Each episode of direct observation included a single protein drug in some point of the supply chain and considered all the elements in the work system. Based on the results of the work system analysis and the literature review, the authors propose a list of items which could be assumed as Best Current Practice for PDs handling in hospitals. There were a total of 34 observations involving 19 PDs. Regarding People involved in the work process, there was a diversity of professionals with different previous training and knowledge, leading to an information gap. With respect to Environment, some structural and organizational differences between hospitals lead to risks related to the time exposure of PDs to room temperature and mechanical stress. Some differences also existed in the Tools and Tasks involved in the process, being especially relevant to the lack of compatibility information of PDs with new technologies, such as pneumatic tube system, robotic reconstitution, or closed-system transfer devices. Finally, 15 suggestions for best current practice are proposed. Main barriers found for compliance with accepted recommendations were related to the information gap detected in professionals involved in the handling of protein drugs, unmonitored temperature, and the lack of compatibility information of protein drugs with some new technologies. By applying a Human Factors and Systems Engineering Approach, the comparison of two European hospitals has led to a suggested list of Best Current Practices in the handling of protein drugs in a hospital.

Proyecto Trazam: aplicación móvil para la trazabilidad de preparaciones elaboradas en un servicio de farmacia / Trazam project: A mobile application for the tracking of compounded preparations in a Pharmacy Department

Introducción el objetivo principal es describir el diseño e implementación de una aplicación para dispositivos móviles para facilitar el seguimiento de las preparaciones elaboradas en el servicio de farmacia hospitalaria. Los objetivos secundarios fueron evaluar el tiempo dedicado a la resolución de incidencias relacionadas con la dispensación/distribución de las preparaciones pre y postimplantación de la aplicación, conocer el grado de satisfacción de los usuarios y disponer de información cualitativa y cuantitativa del proceso que permita establecer indicadores de seguimiento. Métodos se definieron los requisitos a cumplir por el aplicativo informático, los fármacos susceptibles de entrar en el sistema y los circuitos de entrega. Se procedió al desarrollo de la aplicación por parte del proveedor e integración con los programas informáticos de prescripción/validación. Se crearon y añadieron los códigos QR de identificación en los puntos de entrega de medicamentos en las unidades de destino. Se adquirieron los dispositivos móviles necesarios. Primera etapa de formación de usuarios en la aplicación y prueba piloto en una planta de hospitalización. Posteriormente se inició la fase de expansión y consolidación. Resultados el 86,9% de las preparaciones estériles elaboradas en el servicio de farmacia hospitalaria se han incorporado al sistema, incluyendo quimioterapia, nutriciones parenterales de adultos y otras preparaciones estériles no peligrosas. Se han incluido en la aplicación las salas de hospitalización, los hospitales de día y 2 sedes externas. La media de preparaciones trazadas mensualmente es de 5.403 (DE = 297,3) (AU)

Introduction The primary objective of this study is to describe the design and implementation of a mobile application (App) for tracking preparations compounded in the Pharmacy Department. Secondary objectives include evaluating the time spent on resolving incidents related to the distribution of preparations before and after implementation, assessing users satisfaction with the application, and establishing a panel of quality indicators based on the data extracted from the App. Methods Defining application requirements, identifying drugs to be included in the software and outlining different workflows. Developing the App in collaboration with the supplier and integrating it with the computer programs involved in prescription and validation. Additionally, QR codes were created to identify delivery points at destination units, and suitable mobile devices were acquired. The initial phase involved user training in the application and a pilot test conducted in a hospital ward. The subsequent phase focused on expansion and consolidation. Results The system includes 86.9% of all sterile preparations prepared in the Hospital Pharmacy, encompassing chemotherapy, adult parenteral nutrition, and other non-hazardous sterile preparations. Furthermore, the application has been implemented in all hospitalization wards, day care units and two external sites. On average, 5,403 preparations were tracked per month (SD = 297.3). The time required to address incidents related to the distribution of preparations has decreased by 83% (from 38.9 to 6.6 minutes per day). The App regularly provides valuable management data for optimizing workflow in the compounding area. Additionally, users have expressed satisfaction with the application (AU)

Hernandulcin Production in Elicited Hairy Roots of Phyla scaberrima: Toward Sustainable Production of a Non-Caloric Sweetener with Nutraceutical Properties.

Herein we report on the generation of hairy root lines of P. scaberrima able to produce hernandulcin (HE), a non-caloric sweetener with nutraceutical properties. From ten different lines analyzed, three synthesized up to 100 mg ⋅ L-1 HE under the batch culture conditions standardized in this investigation. Adding elicitors (salicylic acid, chitin, Glucanex, polyethylene glycol) and biosynthetic precursors (farnesol and (+)-epi-alpha-bisabolol) significantly altered HE accumulation. Chitin and Glucanex enhanced HE production from 130 to 160 mg ⋅ L-1 , whereas farnesol and (+)-epi-alpha-bisabolol from 165 to 200 mg ⋅ L-1 without dependence on biomass accumulation. Improved batch cultures containing liquid Murashige & Skoog medium (MS; pH 7), added with 4 % sucrose, 0.5 mg ⋅ L-1 naphthaleneacetic acid, 100 mg ⋅ L-1 Glucanex, 150 mg ⋅ L-1 chitin, 250 mg ⋅ L-1 farnesol, and 150 mg ⋅ L-1 (+)-epi-alpha-bisabolol at 25 °C (12 h light/12 h darkness), triggered HE accumulation to 250 mg ⋅ L-1 in 25 days. The efficiency of each recombinant line is discussed.

Trazam project: A mobile application for the tracking of compounded preparations in a Pharmacy Department. / Proyecto Trazam: aplicación móvil para la trazabilidad de preparaciones elaboradas en un servicio de farmacia.

INTRODUCTION: The primary objective of this study is to describe the design and implementation of a mobile application (App) for tracking preparations compounded in the Pharmacy Department. Secondary objectives include evaluating the time spent on resolving incidents related to the distribution of preparations before and after implementation, assessing users satisfaction with the application, and establishing a panel of quality indicators based on the data extracted from the App. METHODS: Defining application requirements, identifying drugs to be included in the software and outlining different workflows. Developing the App in collaboration with the supplier and integrating it with the computer programs involved in prescription and validation. Additionally, QR codes were created to identify delivery points at destination units, and suitable mobile devices were acquired. The initial phase involved user training in the application and a pilot test conducted in a hospital ward. The subsequent phase focused on expansion and consolidation. RESULTS: The system includes 86.9% of all sterile preparations prepared in the Hospital Pharmacy, encompassing chemotherapy, adult parenteral nutrition, and other non-hazardous sterile preparations. Furthermore, the application has been implemented in all hospitalization wards, day care units and two external sites. On average, 5,403 preparations were tracked per month (SD = 297.3). The time required to address incidents related to the distribution of preparations has decreased by 83% (from 38.9 to 6.6 minutes per day). The App regularly provides valuable management data for optimizing workflow in the compounding area. Additionally, users have expressed satisfaction with the application. DISCUSION: The proposed application enables hospital staff to easily and intuitively track preparations compounded in the pharmacy, irrespective of the computer program used for prescription. It has significantly reduced the need for manual record-keeping and has mitigated incidents associated with the distribution of sterile preparations.

[Translated article] Trazam project: A mobile application for tracking preparations compounded in a pharmacy department.

INTRODUCTION: The primary objective of this study is to describe the design and implementation of a mobile application (App) for tracking preparations compounded in the Pharmacy Department. Secondary objectives include: i) evaluating the time spent on resolving incidents related to the distribution of preparations before and after implementation, ii) assessing users satisfaction with the application, and iii) establishing a panel of quality indicators based on the data extracted from the App. METHODS: 1) Defining application requirements, identifying drugs to be included in the software and outlining different workflows. 2) Developing the App in collaboration with the supplier and integrating it with the computer programs involved in prescription and validation. Additionally, QR codes were created to identify delivery points at destination units, and suitable mobile devices were acquired. The initial phase involved user training in the application and a pilot test conducted in a hospital ward. 3) The subsequent phase focused on expansion and consolidation. RESULTS: The system includes 86.9% of all sterile preparations prepared in the Hospital Pharmacy, encompassing chemotherapy, adult parenteral nutrition, and other non-hazardous sterile preparations. Furthermore, the application has been implemented in all hospitalisation wards, day care units and two external sites. On average, 5403 preparations were tracked per month (SD = 297.3). The time required to address incidents related to the distribution of preparations has decreased by 83% (from 38.9 to 6.6 min per day). The App regularly provides valuable management data for optimising workflow in the compounding area. Additionally, users have expressed satisfaction with the application. DISCUSION: The proposed application enables hospital staff to easily and intuitively track preparations compounded in the Pharmacy, irrespective of the computer program used for prescription. It has significantly reduced the need for manual record-keeping and has mitigated incidents associated with the distribution of sterile preparations.

Extraction methods and nutritional characterization of protein concentrates obtained from bean, chickpea, and corn discard grains.

Protein concentrates obtained from discarded grain flours of white chickpea Sinaloa (Cicer arietinum) (CC), "Azufrazin" bean (Phaseolus vulgaris) (BC), and white corn (Zea mays) (MC), were characterized biochemically through bromatological analyses (protein, lipid, fiber, moisture, ashes, and nitrogen free extract), HPLC techniques (amino acids content), and spectrophotometry (anti-nutrients: phytic acid, trypsin inhibitors, and saponins). The percentage of protein obtained from CC, BC, and MC was 71.23, 81.10, and 55.69%, respectively. Most peptides in the BC and CC flours had a molecular weight of <1.35 kDa, meanwhile, MC peptides were heavier (1.35 to 17 kDa). The amino acids (AA) profile of flours and protein concentrates were similar; however, all the protein concentrates showed an increased AA accumulation (300 to -400%) compared with their flours. The protein concentrates from BC registered the highest AA accumulation (77.4 g of AA/100 g of protein concentrates). Except for the phytic acid in CC and trypsin inhibitor in CC and MC, respectively, the rest of the protein concentrates exhibited higher amounts of the anti-nutrients compared with their flours; however, these levels do not exceed the reported toxicity for some animals, mainly when used in combination with other ingredients for feed formulations. It is concluded that CC and BC protein concentrates showed better nutritional characteristics than MC (level of protein, size of peptides, and AA profile). After biochemical characterization, protein concentrates derived from by-products have nutritional potential for the animal feed industry.

Spanish cohort of VEXAS syndrome: clinical manifestations, outcome of treatments and novel evidences about UBA1 mosaicism.

BACKGROUND: The vacuoles, E1-enzyme, X linked, autoinflammatory and somatic (VEXAS) syndrome is an adult-onset autoinflammatory disease (AID) due to postzygotic UBA1 variants. OBJECTIVES: To investigate the presence of VEXAS syndrome among patients with adult-onset undiagnosed AID. Additional studies evaluated the mosaicism distribution and the circulating cytokines. METHODS: Gene analyses were performed by both Sanger and amplicon-based deep sequencing. Patients' data were collected from their medical charts. Cytokines were quantified by Luminex. RESULTS: Genetic analyses of enrolled patients (n=42) identified 30 patients carrying UBA1 pathogenic variants, with frequencies compatible for postzygotic variants. All patients were male individuals who presented with a late-onset disease (mean 67.5 years; median 67.0 years) characterised by cutaneous lesions (90%), fever (66.7%), pulmonary manifestations (66.7%) and arthritis (53.3%). Macrocytic anaemia and increased erythrocyte sedimentation rate and ferritin were the most relevant analytical abnormalities. Glucocorticoids ameliorated the inflammatory manifestations, but most patients became glucocorticoid-dependent. Positive responses were obtained when targeting the haematopoietic component of the disease with either decitabine or allogeneic haematopoietic stem cell transplantation. Additional analyses detected the UBA1 variants in both haematopoietic and non-haematopoietic tissues. Finally, analysis of circulating cytokines did not identify inflammatory mediators of the disease. CONCLUSION: Thirty patients with adult-onset AID were definitively diagnosed with VEXAS syndrome through genetic analyses. Despite minor interindividual differences, their main characteristics were in concordance with previous reports. We detected for the first time the UBA1 mosaicism in non-haematopoietic tissue, which questions the previous concept of myeloid-restricted mosaicism and may have conceptual consequences for the disease mechanisms.

Are iodophor-impregnated drapes associated with lower intraoperative contamination compared to no adhesive drape?: A protocol for systematic review and meta analysis.

BACKGROUND: Surgical site infection (SSI) is one of the most frightening complications after surgery. Adhesive drapes (AD) are widely used as an infection prevention tool. They can be non-impregnated or iodophor-impregnated, although non-impregnated are less used as they might be related to higher number of infections. One of the most common ways to study their efficacy is by analyzing the intraoperative contamination, which is a useful primary endpoint as it does not need follow-up and it has been strongly associated with infections. Therefore, we believe a systematic review (SR) and meta-analysis is needed to determine which is the literature available about this topic and to explore their results. METHODS: All randomized controlled trials (RCT) published since 1984 through to January 15, 2023 will be included. Non-human and experimental studies will be excluded. We will only include studies written in English. We will conduct searches in the following electronic databases: MEDLINE (via PubMed), SCOPUS and Web Of Science. The protocol of the SR was registered in PROSPERO under the number CRD42023391651 and was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines. DISCUSSION: The evidence regarding the benefits of using iodophor-impregnated adhesive drapes (IIAD) is scarce. Therefore, this SR and meta-analysis is required to determine if they are related with a lower intraoperative contamination incidence, compared to no AD.

The potential use of acylglycerols on the thermal inactivation of lactic acid bacteria for the manufacture of long-life fermented products.

The effect of acylglycerols on the thermal inactivation of lactic acid bacteria used in the production of fermented products was studied. The starting point was the observation of an increase in thermal sensitivity in the presence of an emulsifier based on mono- and diacylglycerols in the culture medium. Analysis of the emulsifier showed that monoacylglycerols were the compounds responsible for this effect, with monopalmitin being the main contributor. Monostearin, on the other hand, showed significantly less potentiating effect. Interestingly, monoacylglycerols showed a greater bactericidal effect when used individually than when used in combination. On the other hand, the rate of thermal inactivation observed in reconstituted skim milk emulsions was lower than in peptone water emulsions, showing that the presence of proteins and colloidal particles increased the resistance of bacteria to heat treatment. With respect to pH values, a reduction in pH from 6.6 to 5.5 promoted an increase in the rate of thermal death. However, at pH = 5.5, the enhancing bactericidal effect was only detectable when the heat treatment was performed at low temperatures but not at high temperatures. This finding is of interest, since it will allow the design of moderate heat treatments, combining the use of temperature with the addition of acylglycerols, to prolong the shelf life of products fermented with lactic acid bacteria, and minimizing the destruction of desirable compounds that were obtained by the fermentation process.

PAUSATE Study: Prevalence and appropriateness of the use of antimicrobials in Spanish hospitals.

OBJECTIVE: To determine the prevalence and appropriateness of antimicrobial use in Spanish hospitals through a pharmacist-led systematic cross-sectional review. METHOD: A nationwide multicenter cross-sectional study was conducted on  10% of the patients admitted to the participating hospitals on one day in April  2021. Hospital participation was voluntary, and the population was randomly  selected. The study sample was made up of patients who, on the day of the  study, received at least one antimicrobial belonging to groups J01, J02, J04,  J05AB, J05AD or J05AH in the Anatomical Therapeutic Chemical Classification  System. The pharmacist in charge made a record and carried out an evaluation  of the appropriateness of antimicrobial use following a method  proposed and validated by the Pharmaceutical Care of Patients with Infectious  Diseases Working Group of the Spanish Society of Hospital Pharmacy. The  evaluation method considered each of the items comprising antimicrobial  prescriptions. An algorithm was used to assess prescriptions as appropriate,  suboptimal, inappropriate and unevaluableResults: One-hundred three hospitals participated in the study and the treatment of 3,568 patients was reviewed. A total of 1,498 (42.0%) patients received antimicrobial therapy, 424 (28.3%) of them in  combination therapy. The most commonly prescribed antimicrobials were  moxicillin-clavulanic acid (7.2%), ceftriaxone (6.4%), piperacillin-tazobactam  (5.8%), and meropenem 4.0%. As regards appropriateness,  prescriptions were considered appropriate in 34% of cases, suboptimal in 45%,  inappropriate in 19% and unevaluable in 2%. The items that most  influenced the assessment of a prescription as suboptimal were completeness  f medical record entries, choice of agent, duration of treatment and monitoring of efficacy and safety. The item that most influences the  assessment of a prescription as inappropriate was the indication of  ntimicrobial agent. Conclusions: The method used provided information on the prevalence and  appropriateness of the use of antimicrobials, a preliminary step in the design  and implementation of actions aimed at measuring the impact of the use of  ntimicrobials within the antimicrobial stewardship programs.

OBJETIVO: Conocer la prevalencia y el grado de adecuación del uso de  antimicrobianos en los hospitales españoles mediante una revisión sistemática  transversal realizada por farmacéuticos.Método: Estudio multicéntrico, nacional, transversal sobre el 10% de los pacientes ingresados en los hospitales participantes un día del mes de abril  de 2021. La participación de los hospitales fue voluntaria y la selección de la  población aleatoria. De la población se disgregó la muestra de estudio,  constituida por los pacientes que recibían el día del corte al menos un  antimicrobiano perteneciente a los grupos J01, J02, J04, J05AB, J05AD y  J05AH del Sistema de Clasificación Anatómica, Terapéutica y Química. Sobre la  muestra de estudio, el farmacéutico realizó un registro y evaluación de la  adecuación del tratamiento antimicrobiano siguiendo una metódica propuesta y  validada por el Grupo de trabajo de Atención Farmacéutica al Paciente con  nfermedad Infecciosa de la Sociedad Española de Farmacia Hospitalaria. La  metódica de evaluación consideró cada una de las dimensiones que conforman  la prescripción del antimicrobiano e incluyó un algoritmo para calificar la  prescripción global como adecuada, mejorable, inadecuada y no valorable. RESULTADOS: Participaron 103 hospitales y se revisó el tratamiento de 3.568  pacientes, de los que 1.498 (42,0%) recibieron terapia antimicrobiana, 424  (28,3%) en combinación. La prevalencia de los antimicrobianos más frecuentes  fue: amoxicilina-clavulánico 7,2%, ceftriaxona 6,4%, piperacilina- tazobactam 5,8% y meropenem 4,0%. Respecto a la adecuación del  tratamiento la prescripción, fue considerada adecuada en el 34% de los casos,  mejorable en el 45%, inadecuada en el 19% y no valorable en el 2%. Las  dimensiones que más influyeron en la calificación de la prescripción como  mejorable fueron el registro en la historia clínica, la elección del agente, la  duración del tratamiento y la monitorización de la eficacia y seguridad, y como  inadecuada la indicación de antimicrobiano. CONCLUSIONES: La metódica utilizada permite conocer la prevalencia y  adecuación del uso de antimicrobianos, paso previo para diseñar y emprender  acciones de mejora y medir el impacto de su implantación en el marco de los  programas de optimización del uso de antimicrobianos.

Estudio PAUSATE: Prevalencia y adecuación del uso hospitalario de antimicrobianos en España / PAUSATE Study: Prevalence and appropriateness of the use of antimicrobials in Spanish hospitals

Objetivo: Conocer la prevalencia y el grado de adecuación del usode antimicrobianos en los hospitales españoles mediante una revisiónsistemática transversal realizada por farmacéuticos.Método: Estudio multicéntrico, nacional, transversal sobre el 10% de lospacientes ingresados en los hospitales participantes un día del mes deabril de 2021. La participación de los hospitales fue voluntaria y la selección de la población aleatoria. De la población se disgregó la muestrade estudio, constituida por los pacientes que recibían el día del corte almenos un antimicrobiano perteneciente a los grupos J01, J02, J04, J05AB,J05AD y J05AH del Sistema de Clasificación Anatómica, Terapéutica yQuímica. Sobre la muestra de estudio, el farmacéutico realizó un registroy evaluación de la adecuación del tratamiento antimicrobiano siguiendouna metódica propuesta y validada por el Grupo de trabajo de AtenciónFarmacéutica al Paciente con Enfermedad Infecciosa de la Sociedad Española de Farmacia Hospitalaria. La metódica de evaluación consideró cadauna de las dimensiones que conforman la prescripción del antimicrobiano eincluyó un algoritmo para calificar la prescripción global como adecuada,mejorable, inadecuada y no valorable. (AU)

Objective: To determine the prevalence and appropriateness of antimicrobial use in Spanish hospitals through a pharmacist-led systematiccross-sectional review.Method: A nationwide multicenter cross-sectional study was conductedon 10% of the patients admitted to the participating hospitals on one dayin April 2021. Hospital participation was voluntary, and the populationwas randomly selected. The study sample was made up of patients who,on the day of the study, received at least one antimicrobial belonging togroups J01, J02, J04, J05AB, J05AD or J05AH in the Anatomical Therapeutic Chemical Classification System. The pharmacist in charge madea record and carried out an evaluation of the appropriateness of antimicrobial use following a method proposed and validated by the Pharmaceutical Care of Patients with Infectious Diseases Working Group of theSpanish Society of Hospital Pharmacy. The evaluation method consideredeach of the items comprising antimicrobial prescriptions. An algorithm wasused to assess prescriptions as appropriate, suboptimal, inappropriateand unevaluable. (AU)

Foaming and Structural Studies on the Acidic Subunit of Amaranth 11S Globulin Modified with Antihypertensive Peptides as a Function of pH and Ionic Strength.

Some studies aimed at revealing the relationship between protein structure and their functional properties. However, the majority of these reports have been carried out using protein isolates. There are limited reports on the possible relationship between the functional properties and the structure of a purified protein. In this work the amaranth 11S globulin acidic subunit (AAC) and five mutations of the same protein that were modified in their variable regions with antihypertensive peptides (VYVYVYVY and RIPP), were analyzed at two ionic strength (2.9 and 17.6 g/L NaCl) and pH (3.0-7.0). Results revealed better solubility for the proteins mutated at the terminal ends (AACM.1 and AACM.4) and lower solubility for the protein inserted with RIPP peptide. Spectroscopy studies revealed an increase of ß-sheet structure at high salt concentration for all proteins. It was also observed that salt concentration acted as a modulator, which allowed a better foam features for all modified proteins limiting movement of side chains and reducing red-shifted displacement of λmax. All proteins showed foam capacity ranging from 76 to 93% although foam stability was twofold better for modified proteins than for AAC at high salt concentration. This study allowed better understanding about the structural changes that influence the foaming properties of engineered proteins.

Effect of Chitosan Nanoparticles Incorporating Antioxidants from Salvia hispanica L. on the Amaranth Flour Films.

Research background: Amaranth (Amaranthus hypochondriacus) flour produces films with excellent barrier properties against water vapor, allowing food preservation, but the mechanical properties are poor compared to synthetic films. One strategy to improve these properties is the incorporation of nanoparticles. The particles can also serve as a vehicle for the addition of antioxidant agents into the films. The objective of this work is to optimize the formulation for the preparation of amaranth flour films treated with antioxidant chia (Salvia hispanica L.) extract-loaded chitosan particles using response surface methodology (RSM). Experimental approach: Chitosan nanoparticles with the extract were synthesized by ionic gelation, and the films were made by the casting method. Three independent variables were assigned: amaranth flour (4-6%), glycerol (25-35%) and chitosan nanoparticles loaded with the chia extract (0-0.75%). We then evaluated the physical (thickness), mechanical (tensile strength, Young´s modulus and elongation), barrier (water vapor permeability, moisture and water solubility) and antioxidant properties of the films. The experimental results of the properties were analyzed using a Box-Behnken experimental design generating 15 runs with three replicates at the central point. Results and conclusions: Second and third order polynomial models were obtained from the ANOVA analysis of the evaluated responses, and high coefficients of determination were found (0.91-1.0). The water vapor permeability of the films was 0.82-2.39·10-7 (g·mm)/(Pa·s·m2), tensile strength was 0.33-1.63 MPa and antioxidant activity 2.24-5.65%. The variables had different effects on the films: glycerol negatively affected their properties, and the permeability values increased with increased amaranth flour content. The nanoparticles improved the mechanical, barrier and antioxidant properties of the films compared to the films without nanosystems. The optimal formulation was 4% amaranth flour, 25% glycerol and 0.36% chitosan nanoparticles. The optimized films had better mechanical (1.62 MPa) properties, a low water vapor permeability value (0.91·10-7 (g·mm)/(Pa·s·m2)) and moderate antioxidant activity (6.43%). Novelty and scientific contribution: The results show the effect of chitosan nanoparticles on the properties of amaranth flour films for the first time. The resulting equations are useful in the design of food packaging.

Eating and nutritional habits in patients with schizophrenia.

BACKGROUND: There are few studies that relate eating and nutritional habits to the severity of the disease and demographic profile in patients with schizophrenia. OBJECTIVE: To describe eating and nutritional habits and their relationship with the severity of the disease in patients with schizophrenia. METHOD: Cross-sectional descriptive study. SAMPLE: 31 patients with schizophrenia (ICD-10) under outpatient treatment. INCLUSION CRITERIA: age 18-65 years, clinically stable and, written informed consent. ASSESSMENT: Demographic, clinical characteristics (CGI-SCH, length of illness, BMI, abdominal perimeter), ad hoc questionnaire (eating, nutritional, and physical activity). RESULTS: Mean age 43.13(SD = 7.85) years, males 61.3%. Mean severity of illness was 3.94(SD = 1.06), mean duration of the illness 18.42(SD = 8.27) years. 74.2% used to eatweekly fat meat and 64.5% less than 3-4 servings of fish, 77.4% less than 3 servings of fruit per day, and 51.6% drink less than 1 L of water. 83.9% used to drink coffee daily, 2.81(SD = 2.02) cups per day. Patients showed lower levels of Vitamin A, D, E, K1, C, folic acid, and magnesium. 93.5% did not fulfill the WHO recommendations on physical activity. Only retinol (r = -0.602, P = .039) and vitamin K1 (r = -0.693, P = .012) in women were related to the severity of illness. CONCLUSIONS: Outpatients with schizophrenia do not follow WHO recommendations on healthy diets, neither physical activity. Both clinical severity of the illness and marital status and cohabitation were associated with poor eating habits and nutrients deficit. These data should be taken into account by the nursing staff when implementing specific care in routine clinical practice.

Hábitos alimenticios y nutricionales en pacientes con esquizofrenia / Eating and nutritional habits in patients with schizophrenia

Antecedentes: Hay pocos estudios que relacionen los hábitos alimenticios y nutricionales con la gravedad de la enfermedad y el perfil demográfico en pacientes con esquizofrenia.Objetivo: Describir los hábitos alimenticios y nutricionales y su relación con la gravedad de la enfermedad en pacientes con esquizofrenia.Método: Estudio descriptivo transversal. Muestra: 31 pacientes con esquizofrenia (CIE-10) en tratamiento ambulatorio. Criterios de inclusión: edad 18-65 años, clínicamente estable y consentimiento informado por escrito. Evaluación: características demográficas, clínicas (ICG-G, años de evolución de la enfermedad, IMC, perímetro abdominal), cuestionario ad hoc (alimentación, hábito nutricional y actividad física).Resultados: Edad media 43,13 (DE = 7,85) años, varones 61,3%. La gravedad media de la enfermedad fue de 3,94 (DE = 1,06), con una media de 18,42 (DE = 8,27) años evolución de la enfermedad. El 74,2% comía carne grasa semanalmente y el 64,5% menos de 3-4 porciones de pescado, el 77,4% menos de 3 porciones de fruta por día y el 51,6% bebía menos de un litro de agua. El 83,9% tomaba café diariamente, 2,81 (DE = 2,02) cafés por día. Los pacientes presentaban niveles más bajos de vitamina A, D, E, K1, C, ácido fólico y magnesio. El 93,5% no cumplía con las recomendaciones de la OMS sobre actividad física. Solo el retinol (r = -0,602, p = 0,039) y la vitamina K1 (r = -0,693, p = 0,012) en las mujeres se relacionaron con la gravedad de la enfermedad.Conclusiones:Los pacientes con esquizofrenia a seguimiento ambulatorio no siguen las recomendaciones de la OMS sobre dietas saludables ni actividad física. Tanto la gravedad clínica de la enfermedad como el estado civil y la convivencia se asociaron con malos hábitos alimenticios y déficit de nutrientes. Estos datos deben ser tenidos en cuenta por el personal de enfermería a la hora de implementar cuidados específicos en la práctica clínica habitual. (AU)

Background: There are few studies that relate eating and nutritional habits to the severity of the disease and demographic profile in patients with schizophrenia.Objective: To describe eating and nutritional habits and their relationship with the severity of the disease in patients with schizophrenia.Method: Cross-sectional descriptive study. Sample: 31 patients with schizophrenia (ICD-10) under outpatient treatment. Inclusion criteria: age 18-65 years, clinically stable and, written informed consent. Assessment: Demographic, clinical characteristics (CGI-SCH, length of illness, BMI, abdominal perimeter), ad hoc questionnaire (eating, nutritional, and physical activity).Results : Mean age 43.13(SD=7.85) years, males 61.3%. Mean severity of illness was 3.94(SD=1.06), mean duration of the illness 18.42(SD=8.27) years. 74.2% used to eat weekly fat meat and 64.5% less than 3-4 servings of fish, 77.4% less than 3 servings of fruit per day, and 51.6% drink less than 1l of water. 83.9% used to drink coffee daily, 2.81(SD=2.02) cups per day. Patients showed lower levels of Vitamin A, D, E, K1, C, folic acid, and magnesium. 93.5% did not fulfill the WHO recommendations on physical activity. Only retinol (r=-0.602, p=0.039) and vitamin K1 (r=-0.693, p=0.012) in women were related to the severity of illness.Conclusions: Outpatients with schizophrenia do not follow WHO recommendations on healthy diets, neither physical activity. Both clinical severity of the illness and marital status and cohabitation were associated with poor eating habits and nutrients deficit. These data should be taken into account by the nursing staff when implementing specific care in routine clinical practice. (AU)

Engineering Concanavalin B to Release Bioactive Peptides against Metabolic Syndrome.

Metabolic syndrome is a severe public health issue characterized by multiple metabolic disturbances. Current treatments prescribe a particular drug for each of them, producing multiple side effects. As a first step towards a more integral approach, we applied our recently described methodology to design single proteins, based in the Concanavalin B scaffold (1CNV), that contain several bioactive peptides (BPs), including antioxidant and lipid-lowering activities as well as inhibitors of dipeptidyl peptidase IV (DPPIV) and the angiotensin converting enzyme. Modified Concanavalin (CNV44), the designed protein that showed the best in silico properties, was expressed in high yields in E. coli and purified to homogeneity. After in vitro digestion with gastrointestinal enzymes, all the biological activities tested where higher in CNV44 when compared to the non-modified protein 1CNV, or to other previous reports. The results presented here represent the first in vitro evidence of a modified protein with the potential to treat metabolic syndrome and open the venue for the design of proteins to treat other non-communicable diseases.

Synthesis and Characterization of Chitosan Particles Loaded with Antioxidants Extracted from Chia (Salvia hispanica L.) Seeds.

Chia (Salvia hispanica L.) seeds contain antioxidants with great benefits for health and are widely used in the food industry. Antioxidants can be degraded by environmental factors, decreasing their biological activity. Their encapsulation in chitosan (CH) particles represents an alternative to protect them and increases their application. The encapsulation efficiency (%EE) of the antioxidants in the CH particles depends on the synthesis conditions. In this study, two methods for encapsulation of chia extract in chitosan particles were evaluated: method A, 0.05% CH in 1% acetic acid was mixed with 0.07% of tripolyphosphate (TPP) and method B, 0.3% CH in 2% acetic acid was mixed with 1% TPP. The results showed that the %EE decreased with the concentration of the extract, and the FTIR analysis suggested that the compounds of the extract were adsorbed on the surface of the particles. Dynamic light scattering and zeta potential analysis showed that the particles of method A are unstable and with a tendency to agglomerate, and the particles of method B are stable. The highest %EE was obtained with 0.2 mg·mL-1 (method A) and 1.0 mg·mL-1 (method B) of the extract. The higher loading capacity (%LC) (16-72%) was exhibited by the particles of method A. The best particle yield (62-69%) was observed for method B. The particles with the extract adsorbed showed antioxidant activity (5-60%) at 25°C; however, in the particles with the extract encapsulated, the activity increased after subjecting to acidic conditions at 40°C due to the breakdown of the particles. The results obtained will allow choosing the appropriate conditions for the synthesis of chitosan particles loaded with chia extracts with specific characteristics (%EE, %LC, size, and type) according to their future applications. The particles could be used in food and pharmaceutical industries and even in edible films for food packaging.

Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review.

OBJECTIVE: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. METHODS: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. RESULTS: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5-50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0-31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5-50.0) to 5.0 (0.0-5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0-14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0-46.0) versus 45.0 (38.0-57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0-38.0) versus 6.0 (1.0-23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7-5.6) versus 1.3 (0.3-3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. CONCLUSION: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.

A rare case of voluminous brain abscess due to Actinomyces meyeri and Aggregatibacter aphrophilus: is there any evidence for a prolonged antibiotic oral relay?

We present the case of a patient with a voluminous cerebral abscess caused by Aggregatibacter aphrophilus and Actinomyces meyeri occurring a week post dental scaling. Both these bacteria are rarely involved in brain abscesses, and so far, cases of cerebral actinomyces have mostly been treated surgically and with intravenous (IV) antibiotics for 3-4 months, then put on oral antibiotic therapy with penicillin or amoxicillin for a further 3-12 months. Our patient underwent drainage through craniotomy and was subsequently put on intravenous ceftriaxone for 3 months accompanied by brain imaging control at the end of this period which showed complete regression of the abscess. Following parenteral treatment, no oral antibiotics were given since pharmacokinetic properties do not allow to attain high tissue concentration in the brain. This treatment gave excellent results.