Sufficiency for PSS tracking gait disorders in multiple sclerosis: A managerial perspective.

This study primarily aimed to explore the capabilities of digitalisation in the healthcare context, focusing on a specific disease. In this case, the study examined the potential of remote monitoring of gait to address the sensitivity of multiple sclerosis progression to gait characteristics by adopting a non-invasive approach to remotely quantify gait disturbances in a patient's daily life. To better understand the managerial aspects associated with this approach, the researchers conducted a literature review along with a set of semi-structured interviews. The target population included MS patients as well as the key agents involved in their care: patients' family members, neurologists, MS nurses, physiotherapists, medical directors, and pharmacist. The study identifies the perceived barriers and drivers that could contribute to the successful deployment of PSS remote gait monitoring as a healthcare service: i) At mega-level governance. Implications on privacy and security data are notable barriers missing on the speech. ii) At macro level, funding is highlighted as main barrier. The cost and lack of health system subsidies may render initiatives unsustainable, as emphasised by the interviewees. iii) At meso level, useable data is recognised as a driver. The data collection process can align with diverse interests to create value and business opportunities for the ecosystem actors, enhance care, attract stakeholders, such as insurers and pharma, and form partnerships. iv) At micro-level processes, we find two potential barriers: wearable device and app usability (comfort, navigation, efficiency) and organisational/behavioural aspects (training, digital affinity, skills), which are crucial for value creation in innovation ecosystems among patients and healthcare professionals. Finally, we find an interesting gap in the literature and interviews. Stakeholders' limited awareness of technological demands, especially from information technologies, for a successful long-term service, can be consider two key barriers for PSS.

Bioprospecting of endophytic fungi from semidesert candelilla (Euphorbia antisyphilitica Zucc): Potential for extracellular enzyme production.

Endophytic microbial communities colonize plants growing under various abiotic stress conditions. Candelilla (Euphorbia antisyphilitica Zucc.) is a shrub that develops functionally in arid and semi-arid zones of Mexico; these conditions generate an association between the plant and the microorganisms, contributing to the production of enzymes as a defense mechanism for resistance to abiotic stress. The objective of this research was to isolate and identify endophyte fungi of candelilla and bioprospection of these endophytic fungi for enzyme production using candelilla by-products. Fungi were isolated and identified using ITS1/ITS4 sequencing. Their potency index (PI) was evaluated in producing endoglucanase, xylanase, amylase, and laccase. Fermentation was carried out at 30°C for 8 days at 200 rpm, with measurements every 2 days, using candelilla by-products as substrate. All fungi exhibited higher cellulase, amylase, and laccase activities on the 2nd, 6th, and 8th day of fermentation, respectively, of fermentation. The fungus Aspergillus niger ITD-IN4.1 showed the highest amylase activity (246.84 U/mg), the genus Neurospora showed the highest cellulase activity, reaching up to 13.45 FPU/mg, and the strain Neurospora sp. ITD-IN5.2 showed the highest laccase activity (3.46 U/mg). This work provides the first report on the endophytic diversity of E. antisyphilitica and its potential role in enzyme production.

Grape Pomace-Advances in Its Bioactivity, Health Benefits, and Food Applications.

From a circular economy perspective, the appropriate management and valorization of winery wastes and by-products are crucial for sustainable development. Nowadays, grape pomace (GP) has attracted increasing interest within the food field due to its valuable content, comprising nutritional and bioactive compounds (e.g., polyphenols, organic and fatty acids, vitamins, etc.). Particularly, GP polyphenols have been recognized as exhibiting technological and health-promoting effects in different food and biological systems. Hence, GP valorization is a step toward offering new functional foods and contributing to solving waste management problems in the wine industry. On this basis, the use of GP as a food additive/ingredient in the development of novel products with technological and functional advantages has recently been proposed. In this review, we summarize the current knowledge on the bioactivity and health-promoting effects of polyphenolic-rich extracts from GP samples. Advances in GP incorporation into food formulations (enhancement of physicochemical, sensory, and nutritional quality) and information supporting the intellectual property related to GP potential applications in the food industry are also discussed.

Effect of light stress on lutein production with associated phosphorus removal from a secondary effluent by the autoflocculating microalgae consortium BR-UANL-01.

Microalgae have become promising microorganisms for generating high-value commercial products and removing pollutants in aquatic systems. This research evaluated the impact of sunlight intensity on intracellular pigment generation and phosphorus removal from secondary effluents by autoflocculating microalgae consortium BR-UANL-01 in photobioreactor culture. Microalgae were grown in a secondary effluent from a wastewater treatment plant, using a combination of low and high light conditions (photon irradiance; 44 µmol m-2 s-1 and ≈ 1270 µmol m-2 s-1, respectively) and 16:8 h light:dark and 24:0 h light:dark (subdivided into 18:6 LED:sunlight) photoperiods. The autoflocculant rate by consortium BR-UANL-01 was not affected by light intensity and achieved 98% in both treatments. Microalgae produced significantly more lutein, (2.91 mg g-1) under low light conditions. Phosphate removal by microalgae resulted above 85% from the secondary effluent, due to the fact that phosphorus is directly associated with metabolic and replication processes and the highest antioxidant activity was obtained in ABTS•+ assay by the biomass under low light condition (51.71% µmol ET g-1). In conclusion, the results showed that the autoflocculating microalgae consortium BR-UANL-01 is capable of synthesizing intracellular lutein, which presents antioxidant activity, using secondary effluents as a growth medium, without losing its autoflocculating activity and assimilating phosphorus.

Fluorofenidone enhances cardiac contractility by stimulating CICR and CaV1.2.

Fluorofenidone (AKF-PD) is a novel pyridone derivative that inhibits fibrosis and inflammation in many tissues. Accordingly, it has been effective in disease models, such as liver failure, nephropathy, and pulmonary fibrosis. However, its potential role in cardiac physiology and pathology has yet to be elucidated. Thus, this paper investigated a possible functional impact of AKF-PD on adult rat cardiac myocytes. Cells were kept in culture for 1-2 days under either control conditions or the presence of AKF-PD (500 µM). They were next examined concerning cell contractility, intracellular Ca2+ homeostasis, and activity of voltage-gated Ca2+ channels. Remarkably, AKF-PD enhanced the percentage of cell shortening and rates of both contraction and relaxation by nearly 100%. A stimulus in Ca2+-induced Ca2+ release (CICR) most likely accounts for these effects because AKF-PD also increased the magnitude of electrically evoked Ca2+ transients. Of note, the compound did not alter the peak value of caffeine-elicited Ca2+ transients, indicating stimulation of CICR at constant sarcoplasmic reticulum Ca2+ load. Since CICR is triggered by the entry of Ca2+ through CaV1.2 (ICa), a possible effect on these Ca2+ channels was also investigated. AKF-PD increased the magnitude of both ICa and maximal macroscopic Ca2+ conductance (Gmax) by about 50%. However, no differences were found in either voltage dependence of inactivation or the amount of maximal immobilization-resistant charge movement (Qmax). Thus, the effect on ICa could be explained by a higher channel's open probability (Po) rather than a greater abundance of channel proteins. Additional data indicate that AKF-PD reduces the rate of Ca2+ extrusion in the presence of caffeine, suggesting inhibition of the Na/Ca exchanger. Overall, these results indicate that AKF-PD upregulates the Po of CaV1.2 and then sequentially enhances ICa, CICR, and contractility. Therefore, the novel compound is also a candidate to be tested in cardiac disease models.

Impact of Fat Replacement by Using Organic-Candelilla-Wax-Based Oleogels on the Physicochemical and Sensorial Properties of a Model Cookie.

Oleogelation is an alternative process to improve the nutritional properties of food by creating soft-matter structures with the same functionality as commercial fats (shortenings). In this study, oleogels were produced by adding organic candelilla wax at 3% (OC03), 6% (OC06), and 9% (OC09) to extra-virgin linseed oil, and then characterized by their physicochemical properties. Furthermore, the physicochemical and sensorial properties of five cookie formulations were evaluated. Organic candelilla wax influenced the oleogel formulations, giving higher values of color (L* and b*), texture, acidity index, and melting point. In the cookie formulations, the luminosity values decreased when the percentage of oleogel was increased; reddish trends were obtained (a* values) for the cookie where 70% of the fat was replaced by the oleogel (C70), and more yellow trends were obtained (b* values) for C100. The moisture content was higher in cookies with oleogels, but it was within quality limits. The percentage of fat migration was lower in cookies with a mixture of fats and oleogels. In terms of hardness, the substitution of oleogels resulted in softer cookies. In terms of the sensory evaluation, the most accepted cookie was C70. Therefore, this study demonstrates the possibility of using organic-candelilla-wax-based oleogels in a real food model rich in unsaturated fats.

The Insecticidal Activity of Azadirachta indica Leaf Extract: Optimization of the Microencapsulation Process by Complex Coacervation.

The objective of the present work was to optimize the microencapsulation conditions of neem (Azadirachta indica A. Juss) leaf extracts for the biocontrol of Tenebrio molitor. The complex coacervation method was used for the encapsulation of the extracts. The independent factors considered were the pH (3, 6, and 9), pectin (4, 6, and 8% w/v), and whey protein isolate (WPI) (0.50, 0.75, and 1.00% w/v). The Taguchi L9 (33) orthogonal array was used as the experimental matrix. The response variable was the mortality of T. molitor after 48 h. The nine treatments were applied by immersion of the insects for 10 s. The statistical analysis revealed that the most influential factor on the microencapsulation was the pH (73% of influence), followed by the pectin and WPI (15% and 7% influence, respectively). The software predicted that the optimal microencapsulation conditions were pH 3, pectin 6% w/v, and WPI 1% w/v. The signal-to-noise (S/N) ratio was predicted as 21.57. The experimental validation of the optimal conditions allowed us to obtain an S/N ratio of 18.54, equivalent to a T. molitor mortality of 85 ± 10.49%. The microcapsules had a diameter ranging from 1-5 µm. The microencapsulation by complex coacervation of neem leaf extract is an alternative for the preservation of insecticidal compounds extracted from neem leaves.

Characterization of Cosmos sulphureus Cav. (Asteraceae): Phytochemical Screening, Antioxidant Activity and Chromatography Analysis.

Cosmos sulphureus Cav. (Asteraceae), and endemic plant of Mexico is used in herbal medicine. In this study, the phytochemical composition, phenolic content, and antioxidant activity of ethanolic and methanolic extracts from C. sulphureus leaves and flowers were determined. The phytochemical analysis showed the presence of compounds such as terpenoids, phenolic compounds, tannins, and flavonoids and the absence of alkaloids, saponins, glycosides, and anthraquinones. The experimental results showed that the extracts have high contents of phenolic, flavonoid, and condensed tannins contents. The phenolic compounds identified in the C. sulphureus extracts by high-performance thin-layer chromatography (HPTLC) include phenolic acids such as chlorogenic acid and caffeic acid as well flavonoids such as rutin and quercetin. The C. sulphureus extracts showed a relevant free radical scavenging activity, ferric-reducing antioxidant power, lipid peroxidation inhibition ability, and oxygen radical antioxidant capacity. This research highlights the phytochemical profile and antioxidant activity of phenolic compounds-rich extracts from C. sulphureus leaves and flowers.

Oxidative stress in early metabolic syndrome impairs cardiac RyR2 and SERCA2a activity and modifies the interplay of these proteins during Ca2+ waves.

We investigated how oxidative stress (OS) alters Ca2+ handling in ventricular myocytes in early metabolic syndrome (MetS) in sucrose-fed rats. The effects of N-acetyl cysteine (NAC) or dl-Dithiothreitol (DTT) on systolic Ca2+ transients (SCaTs), diastolic Ca2+ sparks (CaS) and Ca2+ waves (CaW), recorded by confocal techniques, and L-type Ca2+ current (ICa), assessed by whole-cell patch clamp, were evaluated in MetS and Control cells. MetS myocytes exhibited decreased SCaTs and CaS frequency but unaffected CaW propagation. In Control cells, NAC/DTT reduced RyR2/SERCA2a activity blunting SCaTs, CaS frequency and CaW propagation, suggesting that basal ROS optimised Ca2+ signalling by maintaining RyR2/SERCA2a function and that these proteins facilitate CaW propagation. Conversely, NAC/DTT in MetS recovered RyR2/SERCA2a function, improving SCaTs and CaS frequency, but unexpectedly decreasing CaW propagation. We hypothesised that OS decreases RyR2/SERCA2a activity at early MetS, and while decreased SERCA2a favours CaW propagation, diminished RyR2 restrains it.

Influence of the Extraction Method on the Polyphenolic Profile and the Antioxidant Activity of Psidium guajava L. Leaf Extracts.

The leaves of Psidium guajava L. are an agro-industrial by-product with an outstanding content of polyphenolic compounds; however, there are many factors which can affect the phytochemical profile when valuing this type of plant material, such as temperatures and extraction times involving in the extraction methods applied. In this context, this study analyzed the impact of different extraction methods (Soxhlet, maceration and ultrasound-assisted extraction) on the phytochemical profile (FTIR and UPLC-MS) and the antioxidant activity (ABTS, FRAP and Folin-Ciocalteu) of guava leaf extracts. A yield of phenolic compounds per gram of guava leaf was obtained within the range of 16 to 45 mg/g; on the other hand, the IC50 values determined with the ABTS assay ranged between 78 ± 4 to 152 ± 12 µg/mL. The methanolic extract obtained by Soxhlet was the one with the best reducing power, both in the FRAP assay and in the Folin-Ciocalteu assay. Finally, bioactive compounds such as quercetin, kaempferol and avicularin were identified in the guava leaf extract. It was concluded that the purification of polyphenolics compounds improves the antioxidant capacity, and that the extraction method greatly influences the phytochemical profile and activity of the extracts.

Risk and prognostic factors for SARS-CoV-2 infection in Spanish population with multiple sclerosis during the first five waves.

Background: Data on coronavirus disease 2019 (COVID-19) incidence in patients with multiple sclerosis (MS) during the first wave have been published but are scarce for the remaining waves. Factors associated with COVID-19 infection of any grade are also poorly known. The aim of this study was to analyze the incidence, clinical features, and risk factors for COVID-19 infection of any grade in patients with MS (pwMS) during waves 1-5. Methods: This study prospectively analyzes the cumulative incidence of COVID-19 from the first to the fifth waves by periodic case ascertainment in pwMS followed at the University Hospital of Getafe (UHG). Global and stratified cumulative incidence was calculated. Logistic regression models were used to estimate the weight of selected variables as risk and prognostic factors. Results: We included 431 pwMS, of whom 86 (20%) were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The overall cumulative incidence of confirmed cases was similar to that of Madrid (13,689 vs. 13,307 per 100,000 habitants) but 3 times higher during the first wave and slightly lower from the second to the fifth waves. The majority (86%) of pwMS developed mild forms of COVID-19. Smoking was the only factor associated with a decreased risk of SARS-CoV2 infection of any grade [odds ratio (OR) 0.491; 95% CI 0.275-0.878; p = 0.017]. Risk factors associated with severe forms were Expanded Disability Severity Scale (EDSS) ≥3.5 (OR 7.569; 95% CI 1.234-46.440) and pulmonary disease (OR 10.763; 95% CI 1.27-91.254). Conclusion: The incidence of COVID-19 was similar in this MS cohort to the general population. Smoking halved the risk of being infected. Higher EDSS and pulmonary comorbidity were associated with an increased risk of severe forms.

Candelilla Wax Extracted by Traditional Method and an Ecofriendly Process: Assessment of Its Chemical, Structural and Thermal Properties.

A comparative study was carried out on the chemical, structural and thermal properties of candelilla wax from four wax-producing communities in Mexico, which was obtained by two extraction processes, the conventional one using sulfuric acid (SA) and an eco-friendly alternative process using citric acid (CA) as the extracting agent. The waxes were analyzed by basic chemistry (acidity, saponification, ester indexes, and others), color, Fourier transform infrared spectroscopy (FTIR), Raman micro-spectroscopy, X-ray diffraction (XRD), differential scanning calorimetry (DSC), and hardness and brittleness measurements. The waxes obtained by the environmentally friendly process showed differences in their physicochemical properties when compared to waxes from the conventional process. In addition, they showed some improvements, such as lighter shades and harder waxes, suggesting that the new environmentally friendly process is a viable option.

Patients' self-assessment of essential tremor severity by a validated scale: A useful tool in telemedicine?

INTRODUCTION: There are some validated rating scales to assess severity of Essential tremor (ET), the most common cause of action tremor. Clinical evaluation through telematic consultations has been expanding in the last decade. Patients' self-assessment of tremor severity at home could constitute a useful tool in telemedicine. This paper aims to assess intrarater and interrater reliability of ET severity using Fahn-Tolosa Marin Tremor Rating Scale (FTMTRS) for patients' and neurologists' ratings. MATERIAL AND METHODS: Patients were instructed on how to perform and rate the FTMTRS tasks. Supervised by neurologists, each patient performed one FTMTRS self-assessment at the hospital, which was rated in a blinded way by two neurologists, and six more self-assessments at home afterwards. Postural, intention and specific-tasks tremor were rated. A cumulative linked mixed model was used to assess intrarater and interrater reliability. RESULTS: A total of 161 self-assessments from 19 patients were analyzed. Intrarater reliability of patients' self-ratings at home showed ICCs between 0.843 and 0.962. Interrater ICCs of neurologists' ratings were also excellent for all tremor types (0.903-0.987). Concordance between neurologists' and patients' assessments showed ICCs ranging from 0.407 to 0.824, with the higher agreement for writing/drawing-related tremor (0.824; CI 95% 0.634-0.989). CONCLUSIONS: The rating of ET severity from FTMTRS self-assessments performed by well-trained patients at home could be a suitable clinical measure to assess tremor in non-face-to-face medical consultations. The assessment of tremor during specific tasks could be the most efficient measure for the patient self-assessment at home. These results could be useful in telemedicine.

The secondary metabolites from Beauveria bassiana PQ2 inhibit the growth and spore germination of Gibberella moniliformis LIA.

Fungal secondary metabolites with antimicrobial properties are used for biological pest control. Their production is influenced by several factors as environment, host, and culture conditions. In the present work, the secondary metabolites from fermented extracts of Beauveria bassiana PQ2 were tested as antifungal agents against Gibberella moniliformis LIA. The L18 (21 × 37) orthogonal array from Taguchi methodology was used to assess 8 parameters (pH, agitation, sucrose, yeast extract, KH2PO4, MgSO4, NH4NO3, and CaCl2) in B. bassiana PQ2 submerged fermentation. The ability of the fermented extracts to slow down the growth rate of G. moniliformis LIA was evaluated. The results from 18 trials were analyzed by Statistica 7 software by evaluating the signal-to-noise ratio (S/N) to find the lower-the-better condition. Optimal culture conditions were pH, 5; agitation, 250 rpm; sucrose, 37.5 g/L-1; yeast extract, 10 g/L-1; KH2PO4, 0.8 g/L-1; MgSO4, 1.2 g/L-1; NH4NO3, 0.1 g/L-1; and CaCl2, 0.4 g/L-1, being the agitation at the highest level the most significant factor. The optimal conditions were validated in a sparged bottle bioreactor resulting in a higher S/N value (12.48) compared to the estimate. The extract obtained has the capacity to inhibit the germination of G. moniliformis spores at 24 h. HPLC-ESI-MS2 allowed to identify the water-soluble red pigment as oosporein (m/z 304.9). The secondary metabolites from B. bassiana PQ2 are a suitable alternative to control the growth and sporulation of G. moniliformis.

Mexican Oregano (Lippia graveolens Kunth) as Source of Bioactive Compounds: A Review.

Lippia graveolens is a traditional crop and a rich source of bioactive compounds with various properties (e.g., antioxidant, anti-inflammatory, antifungal, UV defense, anti-glycemic, and cytotoxicity) that is primarily cultivated for essential oil recovery. The isolated bioactive compounds could be useful as additives in the functional food, nutraceuticals, cosmetics, and pharmaceutical industries. Carvacrol, thymol, ß-caryophyllene, and p-cymene are terpene compounds contained in oregano essential oil (OEO); flavonoids such as quercetin O-hexoside, pinocembrin, and galangin are flavonoids found in oregano extracts. Furthermore, thermoresistant compounds that remain in the plant matrix following a thermal process can be priced in terms of the circular economy. By using better and more selective extraction conditions, the bioactive compounds present in Mexican oregano can be studied as potential inhibitors of COVID-19. Also, research on extraction technologies should continue to ensure a higher quality of bioactive compounds while preventing an undesired chemical shift (e.g., hydrolysis). The oregano fractions can be used in the food, health, and agricultural industries.

Spray-drying encapsulation of microwave-assisted extracted polyphenols from Moringa oleifera: Influence of tragacanth, locust bean, and carboxymethyl-cellulose formulations.

In this work, polyphenols from Moringa oleifera (Mor) leaves were extracted by microwave-assisted extraction (MAE) and encapsulated by spray-drying (SD). Particularly, we explored the influence of tragacanth gum (TG), locust bean gum (LBG), and carboxymethyl-cellulose (CMC) as wall-materials on the physicochemical behavior of encapsulated Mor. Single or combined wall-material treatments (100:00 and 50:50 ratios, and total solid content 1%) were tested. The results showed the wall-material had a significant effect on the process yield (55.7-68.3%), encapsulation efficiency (24.28-35.74%), color (yellow or pale-yellow), total phenolic content (25.17-27.49 mg GAE g-1 of particles), total flavonoid content (23.20-26.87 mg QE g-1 of particles), antioxidant activity (DPPH• = 5.96-6.95 mg GAE g-1; ABTS•+ = 5.61-6.18 mg TE g-1 of particles), and particle size distribution (D50 = 112-1946 nm) of the encapsulated Mor. On the other hand, SEM analysis showed smooth and spherical particles, while TGA and DSC analyses confirmed the encapsulation of bioactive compounds based on the changes in thermal peaks. Finally, XRD analysis showed that the particles have an amorphous behavior. The encapsulated Mor produced with individual TG or CMC demonstrated better properties than those obtained from mixed gums. Thus, TG or CMC might be feasible wall materials for manufacturing encapsulated Mor that conserve the phenolic content and antioxidant activity.

Antioxidant activity of polyphenolic compounds obtained from Euphorbia antisyphilitica by-products.

In this study, an alternative extraction technique, ultrasound-assisted extraction, was used to extract the polyphenolic fraction from two different residues of the candelilla plant (Euphorbia antisyphilitica). These metabolites were further analyzed to evaluate their bioactivity as antioxidants. In addition, their functional groups were identified by Fourier transform infrared (FTIR) spectroscopy. The antioxidant assays showed statistically significant differences between the phenolic extracts, with citric acid residues (CAR) exhibiting a higher oxidant effect than sulfuric acid residues (SAR). The CAR from San Jerónimo (SJ) cultivar showed decreased IC50 values (179.441 ± 7.92 µL mL-1, DPPH•), and its polyphenolic fraction was able to inhibit lipid oxidation (70.31 ± 2.50%). FTIR analysis subsequently revealed the presence of functional groups related to polyphenolic compounds, such as hydroxy, carbonyl, carbon double bond, and amine groups. In addition, FTIR spectra showed slight differences in phenolic compounds, due to the strong acid treatment involved in the extraction of wax. The present study demonstrated that candelilla by-products from citric acid-wax extraction have a polyphenolic fraction with strong antioxidant activity, which may be useful in food and pharmaceutical products.