Modification of Dietary Fibers to Valorize the By-Products of Cereal, Fruit and Vegetable Industry-A Review on Treatment Methods.

Many by-products originating from cereal, fruit and vegetable industries contain quite high amounts of dietary fiber (DF), which play an important role in maintaining the healthy state of the human body. Nevertheless, huge proportions of these by-products are still underutilized as feed ingredients, to generate energy within an anaerobic digestion plant or even landfilled. One of the biggest hindrances in the valorization of such by-products is their very low soluble dietary fiber (SDF) to insoluble dietary fiber (IDF) ratios, impairing their nutritional functionality, palatability and technological applicability. Therefore, it is of interest to develop methods that can enhance the SDF to IDF ratio and that can be applied to the by-product streams of the food industry, enabling better valorization perspectives for human nutrition purposes. In this regard, the review paper provides an overview of existing technologies to modify the SDF to IDF ratio in by-products of the food industry by means of physical, chemical and biological treatments. For each type of treatment, available data on application examples including achieved increases in SDF contents are given. Additionally, a comparative discussion regarding the advantages and disadvantages of these methods is provided.

Efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder and nocturia, current clinical features and outcomes: A systematic review.

OBJECTIVE: To evaluate the efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder (OAB) and nocturia. METHODS: A selective database search was conducted to validate the effectiveness of desmopressin in patients with OAB and nocturia. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilised. The meta-analysis included 378 women (five studies) with OAB. The clinical outcomes and adverse events were analysed. RESULTS: The treatment strategy of all the studies included can be divided into three categories: (1) The effect of desmopressin compared with baseline, (2) desmopressin compared with placebo, and (3) desmopressin and anticholinergic combination versus desmopressin monotherapy. There was a significant (50%) reduction in nocturia and urgency episodes after using desmopressin alone. Combined desmopressin and anticholinergic led to a decrease in the frequency of nocturia voids when only using anticholinergic (65% vs. 33.2%). The time increased in the middle to the first nightly voids in the combination arm (65.11 min; p=0.045). The mean incidence (standard deviation) of leak-free episodes was higher under desmopressin than under placebo in the first 4 h (62% [35%] vs. 48% [40%]) and in the first 8 h (55% [37%] vs. 40% [41%]). The safety profile was comparable between treatments. CONCLUSION: Available data indicate that desmopressin is efficacious in significantly reducing nighttime urine production, episodes of nocturia, and urgency episodes. The affectivity of the combination therapy was very high with least side effects for the treatment of OAB/nocturnal polyuria.

Correlation between symptoms and imaging findings including pelvic floor ultrasound to improve the symptom-based diagnosis of female urethral diverticulum (CHECK-UD study).

INTRODUCTION AND HYPOTHESIS: The objective was to establish a model to predict the presence of a female urethral diverticulum (UD) based on symptoms. METHODS: A prospective CHECK-UD study (check of female urethral diverticulum) was conducted. Female patients presenting with symptoms such as lower urinary tract symptoms (LUTS), postmicturition dribble or urinary incontinence (UI), dyspareunia or pain in the pelvic area, and recurrent urinary tract infection (UTI) treated between 2015 and 2020 were included. The association between each symptom variable and the positive finding of UD was evaluated by multivariate logistic regression adjusting for age, body mass index (BMI), vaginal deliveries, previous surgery for SUI, previous pelvic surgery, and microscopic hematuria. A predictive model for the presence of UD was then created. RESULTS: In total, 189 female patients with a minimum of one symptom were enrolled. Pelvic floor ultrasound revealed the presence of UD in 66 out of 189 (34.92%). Of the four symptoms, the combinations "LUTS + postmicturition dribble + UTI," "postmicturition dribble + LUTS," and "UTI + LUTS" were most significantly related to positive findings and had a higher positive prognostic value for the diagnosis of UD than each individual symptom alone (OR = 13.78 [95% CI: 6.95-16.35], p < 0.001; OR = 9.94 [95% CI: 4.60-12.2], p < 0.05; and OR = 5.78 [95% CI: 1.58-6.98] p = 0.05) respectively. CONCLUSION: Based on our model, the combination "LUTS + postmicturition dribble + UTI" seems to be the most sensitive combination of clinical symptoms predicting the positive finding of UD. This model could be used for patient counseling and for the identification of patients with UD.

A systematic review and meta-analysis of clinical and functional outcomes of artificial urinary sphincter implantation in women with stress urinary incontinence.

OBJECTIVE: To evaluate the complications and results of artificial urinary sphincter (AUS) implantation in women with stress urinary incontinence (SUI). METHODS: A selective database search using keywords (1990-2019) was conducted to validate the effectiveness of the AUS in women. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilised. The meta-analysis included 964 women (15 studies) with persistent SUI. The Newcastle-Ottawa score was used to determine the quality of the evidence in each study. The success rate and complications associated with the AUS were analysed. RESULTS: Meta-analysis of the published studies showed that complete continence was achieved at a mean rate of 79.6% (95% confidence interval [CI] 72.2-86.6%) and a significant improvement was achieved in 15% (95% CI 10-25%). The mean (range) follow-up was 22 (6-204) months. The mean number of patients per study was 68. The mean (range) explantation rate was 13 (0-44)%. Vaginal erosion occurred in a mean (range) of 9 (0-27)% and mechanical complications in 13 (0-47)%. Infections accounted for 7% of the complications. The total mean (range) revision rate of the implanted AUS was 15.42 (0-44)%. The mean (range) size of the cuff used was 6.7 (5-10) cm. CONCLUSION: Our present analysis showed that implantation of an AUS in women with severe UI is an effective treatment option after failure of first-line therapy. However, the currently available study population is too small to draw firm conclusions. ABBREVIATIONS: AMS: American Medical Systems; AUS: artificial urinary sphincter; EAU: European Association of Urology; LE: Level of Evidence; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; QoL: quality of life; SHELTER: Services and Health for Elderly in Long TERm care (study); SUI: (stress) urinary incontinence.

Stem cell applications in regenerative medicine for stress urinary incontinence: A review of effectiveness based on clinical trials.

OBJECTIVE: To evaluate the current state, therapeutic benefit and safety of urethral injection of autologous stem cells for the treatment stress urinary incontinence (SUI). MATERIALS AND METHODS: A selective database search of PubMed, the Excerpta Medica dataBASE (EMBASE), Cochrane Library and Google Scholar was conducted to validate the effectiveness of stem cell-based therapy. The search included clinical trials published up until 4 January 2020, written in English, and included cohorts of women and men who had received stem cell-based therapy for SUI. The search used the following keywords in various combinations: 'stem cell therapy', 'cell-based therapy for SUI', 'regenerative medicine for SUI', and 'tissue engineering'. The success rates were assessed according to cough test, urodynamics, pad tests, and International Consultation on Incontinence Questionnaire-Urinary Incontinence. The primary endpoint was continence rate to measure objectively the effect of the treatment. RESULTS: We identified four clinical trials using local injections of adipose-derived stem cells (ADSCs), 11 trails with muscle-derived stem cells (MDSCs), and two trails with human umbilical cord blood stem cells (HUCBs) and total nucleated cells (TNCs). The median improvement rate of intrinsic sphincter deficiency after ADSCs, MDSCs, TNCs, HUCBs injections were 88%, 77%, 89%, 36% (improvement rate: 1-2 pads) at a mean (range) follow-up of 6 (1-72) months. The cell sources, methods of cell processing, cell number, and implantation techniques differed considerably between studies. Most of the periurethral injections were at the 3, 5, 7, and 9 o'clock positions and for submucosa were at the 4, 6, and 8 o'clock positions. No significant postoperative complications were reported. CONCLUSION: Despite many challenges in stem cell-based therapy for treating SUI, it appears to provide, in both male and female patients, acceptable functional results with minimal side-effects and complications. In the future, more clinical trials should be funded in order to optimise stem cell-based therapy and evaluate long-term outcomes. ABBREVIATIONS: ADSC: adipose-derived stem cell; BMSCs: bone marrow-derived mesenchymal stem cell; CLPP: cough leak-point pressure; FPL: functional profile length; HUCB: human umbilical cord blood stem cell; ICIQ-(QOL)(SF)(UI): International Consultation on Incontinence Questionnaire (Quality of life) (-Urinary incontinence Short Form) (-Urinary Incontinence); IIQ-7: Incontinence Impact Questionnaire-short form; I-QOL: Incontinence quality of life questionnaire; ISD: intrinsic urinary sphincter deficiency; MDSC: muscle-derived stem cell; MUCP: maximum urethral closure pressure; NR: not reported; Pdet-max: maximum detrusor pressure; PVR: post-void residual urine volume; Qmax: maximum urinary flow; QOL: quality of life; RP: radical prostatectomy; TNC: total nucleated cell; (S)UI: (stress) urinary incontinence; UDSCs: urine-derived stem cells; UTUS: upper tract ultrasonography; VLPP: Valsalva leak-point pressure.

High moisture extrusion of lupin protein: influence of extrusion parameters on extruder responses and product properties.

BACKGROUND: High moisture extrusion (HME) of lupin protein concentrate and isolate (50:50) mixture was performed by varying the extrusion parameters, such as barrel temperature (138-180 °C), water feed (40-68%) and screw speed (400-1800 rpm). The effect of extrusion parameters on extruder responses [die pressure, product temperature, torque and specific mechanical energy (SME)] and product properties [colour, cutting force, cooking yield, microstructure and in vitro protein digestibility (IVPD)] was evaluated. RESULTS: The multiple regression analysis of the results revealed that the water feed had a significant negative linear effect on the extruder responses considered, as well as on colour difference and cutting force of extrudates. Screw speed had a positive linear effect on product temperature, SME and cooking yield. Barrel temperature affected extruder responses and product properties to a lesser extent. Scanning electron microscopy showed that denser microstructure and higher number of fibre layers were created by increasing temperature and screw speed along with decreasing water feed. The results of IVPD of selected extrudates showed that the increase in barrel temperature decreased the IVPD, whereas the increase in water feed resulted in higher IVPD. The screw speed had no significant effect on IVPD. CONCLUSION: The study demonstrates that the use of lupin protein is feasible to produce meat analogues with HME which could enhance the possibilities to meet the growing protein demands for human consumption. © 2018 Society of Chemical Industry.

Acute macrovascular dysfunction in patients with type 2 diabetes induced by ingestion of advanced glycated ß-lactoglobulins.

OBJECTIVE: Recent evidence indicates that heat-enhanced food advanced glycation end products (AGEs) adversely affect vascular function. The aim of this study was to examine the acute effects of an oral load of heat-treated, AGE-modified ß-lactoglobulins (AGE-BLG) compared with heat-treated, nonglycated BLG (C-BLG) on vascular function in patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: In a double-blind, controlled, randomized, crossover study, 19 patients with T2DM received, on two different occasions, beverages containing either AGE-BLG or C-BLG. We measured macrovascular [brachial ultrasound of flow-mediated dilatation (FMD)] and microvascular (laser-Doppler measurements of reactive hyperemia in the hand) functions at baseline (T0), 90 (T90), and 180 (T180) min. RESULTS: Following the AGE-BLG, FMD decreased at T90 by 80% from baseline and remained decreased by 42% at T180 (P < 0.05 vs. baseline, P < 0.05 vs. C-BLG at T90). By comparison, following C-BLG, FMD decreased by 27% at T90 and 51% at T180 (P < 0.05 vs. baseline at T180). A significant decrease in nitrite (T180) and nitrate (T90 and T180), as well as a significant increase in N(ε)-carboxymethyllisine, accompanied intake of AGE-BLG. There was no change in microvascular function caused by either beverage. CONCLUSIONS: In patients with T2DM, acute oral administration of a single AGE-modified protein class significantly though transiently impaired macrovascular function in concert with decreased nitric oxide bioavailability. These AGE-related changes were independent of heat treatment.

Influencing emulsifying properties of egg yolk by enzymatic modification with phospholipase D. Part 2: structural changes of egg yolk due to incubation.

The effects of a direct incubation of egg yolk (EY) by phospholipase D (PLD) with respect to EY structure and interface properties of oil-in-water (o/w)-emulsions prepared with this EY were investigated. PLD incubation of EY mainly converts phosphatidylcholine into phosphatidic acid (PA). EY structures were characterised using circular dichroism and scanning electron microscopy. Composition (protein and phospholipid contents), charge, and appearance of interfaces in EY stabilised o/w-emulsions were described, too. The improved emulsifying activity of EY after PLD incubation could be attributed both to a higher interface activity of the PA itself and to modified interactions of protein and phospholipids in EY. PA possesses a negative charge resulting in droplet interfaces with higher charge. This effect increased repulsion forces between droplets compared to application of EY without PLD incubation. A higher portion of alpha-helix structures could be detected in the PLD-incubated EY enabling a higher flexibility of proteins on droplet surfaces. Additionally, a better preservation of EY protein structures during heat treatment due to the presence of PA enabled a higher thermal stability of such emulsions.

Influencing emulsifying properties of egg yolk by enzymatic modification by phospholipase D from Streptomyces chromofuscus Part 1: technological properties of incubated egg yolk.

Impact of a direct incubation of egg yolk with phospholipase D (PLD) from Streptomyces chromofuscus was investigated with respect to its effect on rheological and emulsifying properties. Egg yolk has been shown to be a suitable substrate for incubation with PLD after a slight dilution with water (70/30, w/w). A considerable increase of egg yolk viscosity during incubation was observed correlating with formation of phosphatidic acid due to enzymatic activity. Emulsions prepared with such an incubated egg yolk showed a higher viscosity, in particular at high egg yolk concentration. Especially in the case of lower concentrations, smaller droplets indicating better emulsifying activities were detected in emulsions prepared with the incubated egg yolk compared to the application of untreated egg yolk. Stability after heat treatment of the emulsions could be significantly improved by the application of egg yolk incubated with PLD.

Nutritive perfusion of pancreatic endocrine tissue during hemorrhagic hypotension: how differ islets in situ from islet isografts?

Although the exocrine gland frequently has I/R-associated complications such as posttransplant pancreatitis, hypoxia-induced dysfunction of pancreatic endocrine tissue is rarely observed. However, sympathetic hypersensitivity is accused of impaired endocrine function observed in human pancreatic grafts. These tissue-confined differences in susceptibility might be attributed to a distinct islet-specific regulatory control of blood flow (BF). To investigate this hypothesis, intravital microscopy was used for visualization of islets in situ and revascularized islet isografts in Syrian golden hamsters. Blood withdrawal was performed to induce sympathetic stimulation and to evoke an appropriate stress response of the tissue under investigation. Hypotension resulted in a perfusion pressure-dependent reduction of perfusion in both islets in situ and islet isografts. This was associated with comparable microhemodynamics of the tissues in direct vicinity, that is, pancreatic exocrine and host muscle tissue. There was a progressive decrease in functional capillary density of islets in situ and islet isografts that significantly correlated with the stepwise reduction of arterial blood pressure and did not differ in the hypotension-induced perfusion pattern in the neighboring exocrine and host skeletal muscle tissue. Concomitantly, capillary BF in islets in situ and islet isografts and in pancreatic exocrine and host muscle tissue was found to be reduced due to hypotension-associated decreases in capillary diameters and BF velocity. Microvascular perfusion of pancreatic islets and islet isografts is not preserved but strongly parallels perfusion pattern of the neighboring tissue under hemorrhagic stress. This disproves the existence of an individual islet-specific regulatory control of blood flow.

Engineering and biotechnological aspects for the manufacturing of high quality fried potato products.

Fried potato products have become very popular foods over the last decades. High quality standards have been established for these products by the food industry including uniform brown color and crispness. During frying, Maillard reactions takes place which contribute to color and taste development in these products. However, safety aspects are also influenced by these reactions, e.g., acrylamide formation. Maintaining high safety standards as well as the expected quality requires systematic research based on an integrated approach including all relevant variables, e.g., raw material properties, processing conditions and equipment concepts. Selected results of these investigations are presented and discussed, regarding influence of composition, e.g., precursor levels for Maillard reactions, treatment of raw materials and addition of reactants to frying fat. It has been demonstrated that a combined treatment of the potato sticks by coating of product surfaces and partial pre-drying can be successfully applied to produce well-browned French fries with lower acrylamide contents. Reductions up to 75% could be reached compared to samples without treatment. Furthermore, addition of a water/oil emulsion containing glutamine in the aqueous phase has been shown to influence Maillard reactions at the product surface, resulting in lower acrylamide contents at the same state of browning.

Quality related minimization of acrylamide formation--an integrated approach.

An integrated approach is described with respect to acrylamide minimization in heated foodstuffs. All relevant variables have to be considered and the main focus is on maintaining the expected product quality. The role of the processes at the interface between product and heating medium during processing is characterized for the case of frying operations. Examples of parameters influencing these processes with respect to minimizing acrylamide and maintaining product quality (e.g. brown color) are described. First, the local distribution of acrylamide in a French fries type model food was investigated. Lowering water activity at the surface of French fries before frying contributes to a reduction of acrylamide without lowering product quality. Both pre-drying of the potato sticks before frying and an increasing of salt concentration at the product surface by coating with a salt solution showed positive effects. Additionally, it was demonstrated by simulation that combined effects of these measurements may enable a reduction of up to 80% in the acrylamide content.

Detection of circulating prostate cells during radical prostatectomy by standardized PSMA RT-PCR: association with positive lymph nodes and high malignant grade.

BACKGROUND: The purpose of this study was to establish a quantitative standardized RT-PCR for the detection of Prostate Specific Membrane Antigen (PSMA)-expressing circulating cells and to evaluate clinical relevance in patients undergoing radical retropubic prostatectomy (RRP) for clinically localized prostate cancer (PCa). MATERIALS AND METHODS: An external standard molecule (PSMA MIMIC) was constructed for standardization of PSMA RT-PCR reactions. It has the same sequence as endogenous PSMA, except for a central 85 bp deletion, allowing the amplification of both targets simultaneously with nearly the same amplification characteristics as in a nested PCR. PSMA RT-PCR was performed from peripheral blood samples of 73 patients with clinically localized PCa, 4 with metastatic PCa, 27 with benign prostatic hyperplasia (BPH) and 27 controls. Pre, intra- and postoperative blood samples were tested for circulating PSMA expressing cells in 54 out of 73 patients with clinically localized PCa. We also tested intraoperative blood samples of 19 BPH patients treated by transurethral or open surgery. RESULTS: Endogenous PSMA signals from PCa patients varied between 850 and 9900 transcript molecules, corresponding to 2-20 PSMA-expressing cells/ml blood. Standardized RT-PCR using the PSMA MIMIC molecule revealed a significant decrease of "false-positives" in cancer-free controls (p = 0.004). Controls could clearly be distinguished from prostate cancer patients based on PSMA PCR positivity (p = 0.003). Thirty-two % of patients with localized prostate cancer, 11% of BPH patients and 7% of healthy controls were positive in standardized assays compared to 48%, 30% and 27% without PSMA MIMIC, respectively. Preoperatively, a correlation with tumor stage (p = 0.030), grade (p = 0.035) and Gleason Score (p = 0.03) could be demonstrated in clinically localized PCa patients. Dissemination of prostate cells during surgery occurred in 32% of the RRPs and 21% of BPH patients. Positive PCR signals from intraoperative blood samples correlated with positive lymph node status (p = 0.007) and tumor grade (p = 0.005). Postoperative positive results correlated with grade (p = 0.012) and Gleason Score (p = 0.035). CONCLUSION: Counseling the patient with clinically localized prostate cancer can be challenging. Surgery may be, in retrospect, inappropriate in a number of patients due to preoperative understaging. This newly constructed external standard allows quantitative detection of circulating prostate cells, and therefore may open new perspectives for PSMA RT-PCR techniques as diagnostic assays and tools for post-therapeutic follow-up.

p27KIP1-expression in human renal cell cancers: implications for clinical outcome.

BACKGROUND: p27Kip1 (p27) protein is an inhibitor of cyclin-dependent kinase complexes and prevents progression of cells from the G1- to the S-phase of the cell cycle. Decreased p27 expression has been shown to be associated with aggressive tumor behavior and decreased patient survival in numerous human malignancies. The aim of this study was to evaluate p27 expression in renal cell cancer and to assess its association with stage and grade as well as its relationship to patient outcome. MATERIALS AND METHODS: One hundred and fifty-four renal cell carcinoma specimens were evaluated for p27 expression by immunohistochemical staining. Immunohistochemical findings were correlated with tumor grade, tumor stage and patient outcome. RESULTS: A progressive loss of nuclear p27 expression was observed with increasing tumor grade. In poorly-differentiated tumors, p27 expression was significantly lower compared to well- and moderately-differentiated tumors (p = 0.025). p27 expression tended to decrease with increasing tumor stage, but the correlation was not statistically significant (p = 0.068). CONCLUSION: The present study suggests that renal cell carcinomas showed increased aggressiveness with loss of p27 expression. A longer follow-up period will demonstrate whether this cell cycle regulator will provide additional prognostic information in patients with renal cell carcinoma.