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In line with the growing demand for green alternatives to conventional petroleum-derived plastic packaging, fully bio-based and biodegradable biocomposites were developed for this work, for the purpose of packaging dry foods, following the principles of circular economy. Solutions of plasticized chitosan (pCS) were blended with varying amounts of hydrolyzed orange peel (hOP) waste to produce films by casting. The hydrolytic pretreatment of orange peels enabled the creation of biocomposites containing up to 80 wt% hOP, while the formulation with 70 wt% hOP had the best general performance. Chemical characterization of the developed films revealed that chitosan molecules interact electrostatically with pectin molecules in hOP. The strong interaction between chitosan and pectin molecules results in improved mechanical, barrier, and thermal properties of the composite materials compared to their individual components. In addition, the biocomposites exhibit improved water resistance due to their reduced water solubility compared to chitosan and hOP films. The migration of the films’ components in the food simulant Tenax was evaluated, and the results revealed low values, compliant with the current EU regulation. However, due to the electrostatic interactions, the films lost the antimicrobial activity of the individual components, chitosan and hOP, against E. coli and S. aureus bacteria, a property that could turn the developed films into active packaging. Finally, the optical and antioxidant properties and the biodegradability in soil of the developed films were also assayed, showing high transparency, antioxidant capacity, and fast biodegradability, reaching 62.9% weight loss after 26 days of the experiment.

Background: Limited data are available on the effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis (AD). Objective: To investigate COVID-19 outcomes in patients with AD treated with or without systemic immunomodulatory treatments, using a global registry platform. Methods: Clinicians were encouraged to report cases of COVID-19 in their patients with AD in the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Atopic Dermatitis (SECURE-AD) registry. Data entered from 1 April 2020 to 31 October 2021 were analysed using multivariable logistic regression. The primary outcome was hospitalization from COVID-19, according to AD treatment groups. Results: 442 AD patients (mean age 35.9 years, 51.8% male) from 27 countries with strongly suspected or confirmed COVID-19 were included in analyses. 428 (96.8%) patients were treated with a single systemic therapy (n = 297 [67.2%]) or topical therapy only (n = 131 [29.6%]). Most patients treated with systemic therapies received dupilumab (n = 216). Fourteen patients (3.2%) received a combination of systemic therapies. Twenty-six patients (5.9%) were hospitalized. No deaths were reported. Patients treated with topical treatments had significantly higher odds of hospitalization, compared with those treated with dupilumab monotherapy (odds ratio (OR) 4.65 [95%CI 1.71–14.78]), including after adjustment for confounding variables (adjusted OR (aOR) 4.99 [95%CI 1.4–20.84]). Combination systemic therapy which did not include systemic corticosteroids was associated with increased odds of hospitalization, compared with single agent non-steroidal immunosuppressive systemic treatment (OR 8.09 [95%CI 0.4–59.96], aOR 37.57 [95%CI 1.05–871.11]). Hospitalization was most likely in patients treated with combination systemic therapy which included systemic corticosteroids (OR 40.43 [95%CI 8.16–207.49], aOR 45.75 [95%CI 4.54–616.22]). Conclusions: Overall, the risk

HIV infection has been associated with lower rates of sustained viral response (SVR) with direct-acting antivirals (DAAs). There are few data on glecaprevir/pibrentasvir (G/P) in HIV/HCV coinfection outside clinical trials.

The development of mulch films from wastes of vegetables represents a sustainable alternative to the traditionally used polyethylene ones that follow the principles of circular economy. In this work, we obtained films based on two different industrial vegetable wastes, orange peels (OP) and spinach stems (SS), using hydrolysis at different times (6, 16, and 24 h) and temperatures (30, 50, and 70 °C). Hydrolysis carried out at 30 °C and 24 h has led to films with the best mechanical properties, while high temperatures (70 °C) combined with prolonged treatment times (16 and 24 h) led to materials with lower mechanical resistance and darker coloration. The films' characterization by X-ray diffraction (XRD), Fourier Transform infrared spectroscopy (FTIR), nuclear magnetic resonance (NMR), thermogravimetric analysis (TGA), and uniaxial tensile tests elucidated their chemical structure and physicochemical properties. Additionally, the materials' interaction with water was evaluated and significantly improved by adding a carnauba wax coating. Optical properties, micro and macronutrient content and biodegradation in the soil of selected bioplastics were also determined. Results showed that the proposed materials present fast in-soil biodegradation, good potentiality for weed prevention and improvement of plant growth via soil fertilization.

The industrial processing of avocados annually generates more than 1.2 million tons of avocado peels (APs) and avocado seeds (ASs) that have great potential in the production of active bioplastics, although they have never been considered for this aim until now. Separately, the APs and ASs, as well as a combination of avocado peels and seeds (APSs), were evaluated here for the first time for the preparation of antioxidant films, with application in food packaging. Films were prepared by casting, after their processing by three different methods: (1) hydrolysis in acid media, (2) hydrolysis followed by plasticization, and (3) hydrolysis and plasticization followed by blending with pectin polymers in different proportions (25 and 50 wt %). The results indicate that the combination of hydrolysis, plasticization, and pectin blending is essential to obtain materials with competitive mechanical properties, optical clarity, excellent oxygen barrier properties, high antioxidant activity, biodegradability, and migration of components in TENAX suitable for food contact applications. In addition, the materials prepared with APSs are advantageous from the point of view of the industrial waste valorization, since the entire avocado wastes are used for the production of bioplastics, avoiding further separation processes for their valorization.

Objectives: The goal of this study was to develop a risk score model for patients with Brugada syndrome (BrS). Background: Risk stratification in BrS is a significant challenge due to the low event rates and conflicting evidence. Methods: A multicenter international cohort of patients with BrS and no previous cardiac arrest was used to evaluate the role of 16 proposed clinical or electrocardiogram (ECG) markers in predicting ventricular arrhythmias (VAs)/sudden cardiac death (SCD) during follow-up. Predictive markers were incorporated into a risk score model, and this model was validated by using out-of-sample cross-validation. Results: A total of 1,110 patients with BrS from 16 centers in 8 countries were included (mean age 51.8 ± 13.6 years; 71.8% male). Median follow-up was 5.33 years; 114 patients had VA/SCD (10.3%) with an annual event rate of 1.5%. Of the 16 proposed risk factors, probable arrhythmia–related syncope (hazard ratio [HR]: 3.71; p < 0.001), spontaneous type 1 ECG (HR: 3.80; p < 0.001), early repolarization (HR: 3.42; p < 0.001), and a type 1 Brugada ECG pattern in peripheral leads (HR: 2.33; p < 0.001) were associated with a higher risk of VA/SCD. A risk score model incorporating these factors revealed a sensitivity of 71.2% (95% confidence interval: 61.5 to 84.6) and a specificity of 80.2% (95% confidence interval: 75.7 to 82.3) in predicting VA/SCD at 5 years. Calibration plots showed a mean prediction error of 1.2%. The model was effectively validated by using out-of-sample cross-validation according to country. Conclusions: This multicenter study identified 4 risk factors for VA/SCD in a primary prevention BrS population. A risk score model was generated to quantify risk of VA/SCD in BrS and inform implantable cardioverter-defibrillator prescription.