Application of Pomace Powder of Black Carrot as a Natural Food Ingredient in Yoghurt.

Researchers and food manufacturers are investigating the use of fruit and vegetable by-products as nutrient-dense food ingredients in response to increasing consumer requests for healthier and more natural foods. Black carrot (Daucus carota L.), a root vegetable variety of deep purple carrot, is a valuable source of nutrients with excellent health benefits and nutraceutical effects. Black carrot pomace (BCP), a by-product of industrial juice extraction, is abundant in bioactive compounds, dietary fiber, antioxidants, and pigments such as anthocyanins. Value addition and sustainability are perspectives provided by using this underutilized agricultural by-product in food applications. With an emphasis on BCP powder's effects on phytochemical and physicochemical qualities, mineral and color characteristics, and sensory aspects, this study aims to assess the effects of adding BCP powder to yogurt formulations. The findings show that the addition of BCP powder improved the nutritional, and the color of the yogurts, providing a visually appealing product. Moreover, adding the BCP powder raised the amount of phytochemicals and the antioxidant activity in the final product's formulation. The manufacturing of such products can not only aid in promoting sustainable food production but also offer consumers a wider range of innovative food options with improved properties.

Effect of Nasal Continuous Positive Airway Pressure on Retinopathy of Prematurity in Preterm Newborns: A Comparative Analysis with Mechanical Ventilation and High-Flow Nasal Cannula Therapy.

BACKGROUND Retinopathy of prematurity (ROP), originally described as retrolental fibroplasia, represents an abnormal growth of blood vessels in the premature retina that can occur in response to oxygen therapy. The association between ROP and invasive mechanical ventilation has been widely studied in the literature; however, the relationships between different types of ventilation and ROP have not been as well documented. This study aimed to compare the association of ROP incidence with mechanical ventilation (MV), nasal continuous positive airway pressure (nCPAP), and high-flow nasal cannula (HFNC) therapies in 130 pre-term infants with gestational ages <32 weeks. MATERIAL AND METHODS The study includes 130 premature newborns, out of which 54 underwent MV therapy, either alone or in combination with nCPAP or HFNC therapy, 63 underwent nCPAP therapy, either alone or in combination with MV or HFNC therapy, and 23 underwent HFNC therapy, either alone or in combination with MV or nCPAP therapy. The relationships between ROP and the 3 types of ventilation were analyzed by univariate followed by multivariate logistic regression. RESULTS When adjusting for covariates, only nCPAP and birth weight were significantly associated with ROP, the former being a strong risk factor, with an adjusted odds ratio (AOR) of 7.264 (95% CI, 2.622-20.120; P<0.001), and the latter being a weak protective factor, with an AOR of 0.998 (95% CI, 0.996-0.999; P<0.05). CONCLUSIONS The results showed nCPAP was a strong ROP risk factor, birth weight was a weak ROP protective factor, and MV and HFNC were not significantly associated with increased ROP risk.

How Much Does SARS-CoV-2 Infection during Pregnancy Affect the Neonatal Brain, Heart, and Kidney? A Parallel between COVID-19, Vaccination, and Normal Pregnancy.

During the last decades, a growing number of studies have shown that infections during pregnancy have an important impact on both pregnant women and their fetuses. Our goal was to include newborns from pregnancies with SARS-CoV-2 infection and to investigate the extension of neonatal complications using cardiac, abdominal, and cerebral ultrasonography; hearing testing; and indirect ophthalmoscopy. Likewise, neonates whose mothers were vaccinated against COVID-19 during pregnancy and those from pathology-free pregnancies were examined. A total of 458 mother-newborn dyads were included over a period of 10 months and divided into three groups: the COVID-19 group, vaccine group, and control group. Although six cardiac malformations were found in the COVID-19 group, no correlation was made compared to the vaccine and control group (p = 0.07). Grade 1 intraventricular hemorrhage and hypoxic ischemic encephalopathy were the most prevalent among neonates from mothers with SARS-CoV-2 infection (p = 0.002 and p < 0.001, respectively). The kidney anomaly found to be most frequent in this group was grade 1 unilateral hydronephrosis (p < 0.001). COVID-19 disease during the gestational period had no effect on the auditory or visual function. Our findings highlight the importance of implementing proper infection control practices for future mothers, and by continuing to investigate this topic, we can gather valuable insights that will improve neonatal health in this context.

Red Onion Peel Powder as a Functional Ingredient for Manufacturing Ricotta Cheese.

Onion (Allium cepa L.) is a vegetable widely cultivated and consumed due to its rich content in bioactive compounds. Red onion peel (ROP) powder, which is a by-product derived from the onion industry, has been attracting significant interest as a potential functional ingredient for improving the overall quality of foods. The present study explores the potential of ROP powder as a functional ingredient to improve the quality and nutritional value of whey cheese. Despite being frequently viewed as a food processing waste byproduct, ROP is a rich source of bioactive substances, including antioxidants, flavonoids, and dietary fiber, having antioxidant and antibacterial effects. The ROP extract exhibited high amounts of total polyphenols (119.69 ± 2.71 mg GAE/g dw) and antioxidant activity (82.35 ± 1.05%). Different quantities (1 and 3%) of ROP powder were added to cheese formulations, and the subsequent impact on the texture characteristics, sensory attributes, and phytochemical composition of the value-added cheeses was evaluated. The findings show that the addition of ROP powder improved the texture and the color of the cheeses, providing a visually appealing product. Additionally, adding the ROP powder significantly raised the amount of phytochemicals and antioxidant activity (17.08 ± 0.78 µmol TE/g dw for RCROP1, 24.55 ± 0.67 µmol TE/g dw for RCROP2) in the final product's formulation. Moreover, adding powder to cheese is an effective way to increase the value of onion by-products and produce polyphenol-enriched cheese.

Bioactive Components, Applications, Extractions, and Health Benefits of Winery By-Products from a Circular Bioeconomy Perspective: A Review.

Significant waste streams produced during winemaking include winery by-products such as pomace, skins, leaves, stems, lees, and seeds. These waste by-products were frequently disposed of in the past, causing resource waste and environmental issues. However, interest has risen in valorizing vineyard by-products to tap into their latent potential and turn them into high-value products. Wine industry by-products serve as a potential economic interest, given that they are typically significant natural bioactive sources that may exhibit significant biological properties related to human wellness and health. This review emphasizes the significance of winery by-product valorization as a sustainable management resource and waste management method. The novelty of this review lies in its comprehensive analysis of the potential of winery by-products as a source of bioactive compounds, extraction techniques, health benefits, and applications in various sectors. Chemical components in winery by-products include bioactive substances, antioxidants, dietary fibers, organic acids, and proteins, all of which have important industrial and therapeutic applications. The bioactives from winery by-products act as antioxidant, antidiabetic, and anticancer agents that have proven potential health-promoting effects. Wineries can switch from a linear waste management pattern to a more sustainable and practical method by adopting a circular bioeconomy strategy. Consequently, the recovery of bioactive compounds that function as antioxidants and health-promoting agents could promote various industries concomitant within the circular economy.

A Prospective Analysis of the Retinopathy of Prematurity Correlated with the Inflammatory Status of the Extremely Premature and Very Premature Neonates.

Retinopathy of Prematurity (ROP) is a major cause of blindness in premature infants. This study aimed to evaluate the association between inflammatory markers and ROP development in extremely premature and very premature neonates and identify potential inflammatory biomarkers for ROP risk prediction. This prospective study was conducted from January 2021 to January 2023 in two clinical hospitals associated with the "Victor Babes" University of Medicine and Pharmacy Timisoara. The study population comprised neonates with a gestational age of less than 32 weeks. Various inflammatory markers, including total white blood cell count, polymorphonuclear leukocytes, C-reactive protein, interleukin-6, and lactate dehydrogenase, were analyzed from blood samples collected at birth and three days postnatally. ROP was diagnosed and classified following the International Classification of Retinopathy of Prematurity. The study included 48 neonates, 12 Extremely Premature Infants (EPI), and 36 Very Premature Infants (VPI). The EPI group had significantly higher mean interleukin-6 and lactate dehydrogenase levels at birth and three days postnatally than the VPI group. C-reactive protein levels at three days were significantly higher in the VPI group. Umbilical cord inflammation and ROP severity were found to have a statistically significant positive correlation. Half of the EPIs had moderate to severe ROP, significantly more than in the VPI group. The duration of oxygen supplementation, mechanical ventilation, Continuous Positive Airway Pressure (CPAP), gestational age less than 28 weeks, and umbilical cord inflammation at or above stage 3 were significant risk factors for developing ROP stage 2 or above. Elevated CRP and IL-6 were also significantly associated with an increased risk of developing ROP stage 2 or above, highlighting their potential as biomarkers for ROP risk prediction. This study suggests a significant association between inflammatory markers and ROP development in extremely premature and very premature neonates. These findings could contribute to the identification of potential inflammatory biomarkers for ROP risk prediction, improving early diagnosis and intervention strategies for this condition.

The Molecular and Histopathological Assessment of Inflammatory Status in Very and Extremely Premature Infants: A Prospective Study.

Prematurity comes with a varying range of complications, implying a high prevalence of complications and mortality and depending on the severity of prematurity and the sustained inflammation among these infants, which recently sparked an important scientific interest. The primary objective of this prospective study was to establish the degree of inflammation in very (VPIs) and extremely preterm infants (EPIs) in association with the histology findings of the umbilical cord (UC), while the secondary objective was to study the inflammatory markers in the neonates' blood as predictors of fetal inflammatory response (FIR). A total of thirty neonates were analyzed, ten of them being born extremely premature (<28 weeks of gestation) and twenty very premature (28-32 weeks of gestation). The EPIs had considerably higher levels of IL-6 at birth than VPIs (638.2 pg/mL vs. 151.1 pg/mL). The CRP levels at delivery did not vary substantially across groups; however, after days, the EPIs had significantly higher CRP levels (11.0 mg/dL vs. 7.2 mg/dL). In contrast, the LDH was considerably higher in the extremely preterm infants at birth and four days after birth. Surprisingly, the proportions of infants with pathologically increased inflammatory markers did not differ between the EPIs and VPIs. The LDH increased considerably in both groups, although the CRP levels increased exclusively among the VPIs. The stage of inflammation in the UC did not vary substantially between the EPIs and VPIs. The majority of infants were identified with Stage 0 UC inflammation (40% in EPI vs. 55% in VPIs). There was a substantial correlation link between gestational age and newborn weight and a significant inverse correlation among gestational age and IL-6 and LDH levels. There was a strong negative association between weight and IL-6 (rho = -0.349) and LDH (rho = -0.261). The stage of the UC inflammation demonstrated a statistically significant direct connection with IL-6 (rho = 0.461) and LDH (rho = 0.293), but none with the CRP. Further studies involving a bigger population size of preterm newborns are required to validate the findings and analyze more inflammatory markers, while prediction models on inflammatory markers that are measured expectantly, before the onset of preterm labor, need to be created.

A Clean-Label Formulation of Fortified Yogurt Based on Rhododendron Flower Powder as a Functional Ingredient.

The world-wide-dispersed Rhododendron is a tiny, evergreen plant with vivid red or pale pink blossoms that is a member of the Ericaceae family and is well-known for its stunning flowers. To improve yogurt's nutritional profile and sensory qualities, this study investigates an innovative application of Rhododendron flower powder (RFP). The potential health benefits of Rhododendron flowers, which are a rich source of bioactive compounds such as polyphenols and antioxidants, have attracted attention. Consequently, the physicochemical, phytochemical, and sensory qualities of fortifying yogurt with RFP at various concentrations were studied. The results showed that the texture and color of the yogurt were highly influenced by the addition of RFP. The addition of this functional ingredient also resulted in a significant increase in the yogurt's polyphenol content and antioxidant capacity. These findings demonstrate the suitability of RFP in yogurt formulations as a functional food ingredient, being a good source of phenolics.

Value-added salad dressing enriched with red onion skin anthocyanins entrapped in different biopolymers.

In this study, red onion skin extract was used to obtain food ingredients. Complex biopolymeric matrices were dissolved in the anthocyanin-rich aqueous extract, followed by gelation and freeze-drying. Powders were characterized regarding encapsulation efficiency (EE), phytochemical content, color, antioxidant activity, and microstructure. Storage and simulated digestion stability were also assessed. Two powders with high contents of bioactives and antioxidant activity were obtained. The highest EE was acquired for the powder with a higher polysaccharides concentration (V2). In addition, V2 exhibited the best storage stability. The in vitro studies demonstrated that increased carbohydrate concentration delivers the best anthocyanins protection. To prove its functionality, V2 was added to a salad dressing. The addition of powder has improved the concentration of biologically active compounds and the antioxidant activity of the salad dressings. These results support the assumption that microencapsulation may deliver bioactives from red onion skin as functional ingredients for value-added foods.

Value-Added Crackers Enriched with Red Onion Skin Anthocyanins Entrapped in Different Combinations of Wall Materials.

The objective of this study was to encapsulate anthocyanins from red onion skins into different biopolymeric matrices as a way to develop powders with multifunctional activities. Two different variants of powders were obtained using a combination of gelation and freeze-drying techniques and characterized by encapsulation efficiency, antioxidant activity, phytochemical content, and color. Stability during storage and the bioavailability of anthocyanins in the in vitro simulated digestion were also examined. Powder V2, with a higher concentration of polysaccharides than V1, allowed a better encapsulation efficiency (90.53 ± 0.29%) and good stability during storage. Both variants had a high content of phytochemicals and antioxidant activity. In vitro investigations proved that an increased polysaccharides concentration offers the best protection for anthocyanins. Thus, a controlled release of the anthocyanins in the intestinal medium was achieved. The powder with the highest encapsulation efficiency was added to crackers, followed by phytochemical characterization to assess its potential added value. The addition of the micro-particles improved the functional characteristics such as antioxidant activity, showing its suitability for the development of bakery products. The attained results may bring implicit benefits to consumers, who can benefit from improved bioactive concentrations in foodstuffs, with significant health benefits.

Case Report: Novel Biallelic Variants in DNAJC21 Causing an Inherited Bone Marrow Failure Spectrum Phenotype: An Odyssey to Diagnosis.

Bone marrow failure represents an umbrella diagnosis for several life-threatening disorders. In many people, the etiology remains unknown for a long time, leading to an odyssey to diagnosis, with numerous tests performed and sometimes inappropriate treatment. Biallelic pathogenic variants in the DNAJC21 gene were recently discovered to cause bone marrow failure syndrome type 3, having phenotypic overlap with Fanconi anemia, dyskeratosis congenita, Shwachman-Diamond syndrome, and Diamond-Blackfan anemia. Herein, we report an 8-year-old boy, with normal intellect, presenting bone marrow failure; growth retardation; failure to thrive; recurrent infections (including sepsis); cryptorchidia; skeletal, skin, teeth, and hair abnormalities; joint hypermobility; eczema; palpebral ptosis; high myopia; rod-cone retinal dystrophy; and short telomeres. He underwent several tests and evaluations, including genetic investigations (panel and exome sequencing), before the DNAJC21 gene was known to cause disease. Whole-genome sequencing performed at the age of 7 years, identified two novel, pathogenic, and compound heterozygous variants in the DNAJC21 gene: NM_001012339.3:c.148C>T (stopgain-maternal origin), p.Gln50∗ and c.643_644delinsTTT (frameshift paternal origin), and p.Lys215Phefs∗71. He received aggressive treatments for his multisystem disease: blood cell transfusions, high-dose corticosteroids, immunoglobulins, multiple antibiotics, vitamins, growth hormone, and others. However, allogeneic hematopoietic stem cell transplantation was avoided. The clinical evolution of bone marrow failure and recurrent infections stabilized with age, yet the myopia progressed. Exocrine pancreatic insufficiency was not detected. This report widens the molecular and clinical understanding of bone marrow failure syndrome type 3. Genome sequencing directed a precise diagnosis that improved patient management and enabled family genetic counseling.

Bioactive's Characterization, Biological Activities, and In Silico Studies of Red Onion (Allium cepa L.) Skin Extracts.

This study aimed to investigate the thermal stability and biological activities of the phytochemicals from the red onion skins extract, which are a rich source of anthocyanins. Eight anthocyanins were identified in the extract by high-performance liquid chromatography, the most abundant ones being cyanidin 3-O-laminaribioside and cyanidin 3-O-(6″-malonoyl-laminaribioside). The study also involved the assessment of the thermal degradation kinetics of anthocyanins and antioxidant activity in the 75-155 °C temperature range. The thermal degradation kinetics was described using the first-order kinetics model. In terms of thermal stability, increasing the temperature resulted in lower half-life values (t1/2) and higher degradation rate constant values (k) for both anthocyanins and antioxidant activity. The thermodynamic parameters revealed that the phytochemicals' degradation is a non-spontaneous and endothermic reaction. Furthermore, the inhibitory effect of the extract was investigated against the enzymes affiliated with metabolic syndrome, oxidative stress, and inflammatory process diseases. Thus, we also demonstrated that the red onion skins extract exerted inhibitory activity on α-glucosidase, α-amylase, lipase, and lipoxygenase. Considering the high content of bioactives and various biological properties, the red onion skins extract is suitable for multiple applications.

Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants.

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1-3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1-3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1-3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1-3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.

The Value of Imagistics in Early Diagnosis of Tuberous Sclerosis.

Tuberous sclerosis complex is a multisystemic genetic disorder with high phenotypical variability. Its progress frequently brings along autism (61%), epilepsy, intellectual disability (45%), and neurocognitive impairment (Gipson and Johnston, 2017). We are considering the case of an infant suspected with tuberous sclerosis complex by imagistic investigation in the prenatal period. The pre- and postnatal ultrasound, fetal MRI, ophthalmoscopy, and dermatological and neurological examinations were used for diagnosis and follow-up. The seven major and minor criteria were regarded as sufficient for accurate diagnosis.

Clinical relevance of retinal structure in children with laser-treated retinopathy of prematurity versus controls - using optical coherence tomography.

PURPOSE: We aimed to assess the macular anatomy using spectral domain optical coherence tomography (SD-OCT), in children born preterm who had laser-treated retinopathy of prematurity (ROP), and to investigate the relationship between structural changes in macula and visual function. METHODS: Thirty-seven 3-8 years old children were included in the study in two groups: 20 children born preterm [(<34 weeks of gestation, birthweight (BW) <2000 g)] who had laser-treated ROP in the Neonatology Department, Municipal Clinical Emergency Hospital of Timisoara, Romania; and 17 controls (children born at term, without eye disease, matched for age and gender). Spectral domain optical coherence tomography (SD-OCT) imaging (Spectralis OCT) was performed at central fovea and 1 mm nasally. RESULTS: In the ROP group (total 34 eyes), we included both eyes in 14 children, and on one eye in six other children. In the control group, both eyes for all 17 children were included. Central fovea thickness (CFT) was significantly higher in children born preterm and with laser-treated ROP as compared to controls (275 ± 34.8 µm versus 224 ± 27.2 µm; p < 0.001). The laser-treated eyes with ROP had mean best-corrected visual acuity (BCVA) = 0.19 logMAR (20/31 Snellen); 35% had BCVA ≥0.3 logMAR (20/40 Snellen). In receiver operating characteristic curve (ROC) analysis, with BCVA as static variable (category 0 = BCVA ≤0.3 logMAR), the CFT cut-off was 257 µm (sensitivity: 0.917; specificity: 0.661; area under the curve: 0.810, p = 0.001). CONCLUSION: Years after the laser intervention, central fovea was significantly thicker in ROP laser-treated children born preterm when compared to controls. Central fovea thickness (CFT) correlated strongly and inversely with BW and gestational age (GA) at birth, while a CFT value above 257 µm was suggestive for suboptimal visual acuity. The proposed cut-off value needs to be validated in future larger studies.

Refractive and Visual Outcome after Laser-Treated Retinopathy of Prematurity in Western Romania.

OBJECTIVES: The aim of this study is to assess the functional outcomes registered in patients from the Western part of Romania, who have been treated for retinopathy of prematurity, using a laser diode (810mn). MATERIALS AND METHODS: In the current study 52 premature infants with gestational age<34 weeks and a birth weight <2000 grams, 96 eyes in total were included. The functional outcomes were assessed by determining the best corrected visual acuity and refractive error. Statistical analysis used: The data were analysed using the IBM SPSS 20 software. Pearson Correlation was used to assess the strength of the relation between different parameters. OUTCOMES: For the eyes with the best visual function (BCVA between 0.8 and 1.0), mean gestational age was 29,452 weeks (SD = 1.958), mean weight at birth was 1363.38 grams (SD = 304.655), the mean energy used during treatment was 370.73 mW (SD = 95.972), and the mean number of burns applied was 1470.44 (SD = 581.960). The spherical equivalent ranged between -24.6 D and +3.4 D. High astigmatism (>3.0 D) was found in 26 eyes (27.08 %) and anisometropia in 29 patients (55.77%). There is a strong positive correlation, statistically significant (P<0.001) between best corrected visual acuity and spherical equivalent, and a negative correlation, statistically significant (P=0.001), between best corrected visual acuity and the number of impacts during laser treatment. CONCLUSION: A long term follow-up is necessary in order to obtain an improvement in the quality of life and visual function of the patients who received laser treatment for retinopathy of prematurity.