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Carob pulp is a valuable source of cellulose-rich fraction (CRF) for many food applications. This study aimed to obtain and characterize a CRF derived from carob pulp waste after sugar removal and to evaluate its potential use in the 3D printing of cellulose-rich foods. Thus, the extraction of the CRF present in carob pulp (by obtaining the alcohol-insoluble residue) was carried out, accounting for nearly 45% dm (dry matter) of this byproduct. The CRF contained about 24% dm of cellulose. The functional properties (swelling capacity, water retention, and fat adsorption) related to this fraction were determined, showing a value of 5.9 mL/g of CRF and 4.0 and 6.5 g/g of CRF, respectively. Different gels were formulated with a total solids content of 15% wm (wet matter), using potato peel flour as a base and partially substituting with CRF (0% to 8% wm). The cellulose-based gels were characterized in terms of viscosity, water distribution (low-field Nuclear Magnetic Resonance), and printability, while the 3D printed samples were assessed for their textural properties. As the percentage of added CRF increased, the viscosity decreased while the water retention increased. Printability improved when small proportions of CRF (2% to 4%) were used, while it deteriorated for higher percentages (6% to 8%). The textural properties (hardness, adhesiveness, cohesiveness, and gumminess) showed significant changes caused by the addition of CRF, with gels containing 3% to 4% CRF exhibiting the most suitable printing values. In summary, this study demonstrates the significant potential of carob cellulose-based gel as an ingredient in the 3D printing of novel fiber-rich foods, contributing to reducing food waste and promoting sustainable practices within the framework of the circular economy.

This article explores the use of citrus residues as a source of different pectic materials for packaging film production: a water-soluble orange residue extract (WSE) (~5% pectin), semi-pure pectins extracted in citric acid (SP) (~50% pectin), and commercial pure citrus pectins (CP). First, these materials were characterized in terms of chemical composition. Then, films were produced using them pure or mixed with chitosan or glycerol through solvent-casting. Finally, antioxidant activity, functional properties (e.g., mechanical and gas barrier properties), and visual appearance of the films were assessed. WSE films showed the highest antioxidant activity but the lowest mechanical strength with the highest elongation at break (EB) (54%); incorporating chitosan increased the films' strength (Young's modulus 35.5 times higher). SP films showed intermediate mechanical properties, reinforced by chitosan addition (Young's modulus 4.7 times higher); they showed an outstanding dry O 2 barrier. CP films showed a similar O 2 barrier to SP films and had the highest Young's modulus (~29 MPa), but their brittleness required glycerol for improved pliability, and chitosan addition compromised their surface regularity. Overall, the type of pectic material determined the film's properties, with less-refined pectins offering just as many benefits as pure commercial ones.

The impact of cryogenic pretreatments on drying performance was studied in blueberries, seabuckthorn fruits and green grapes. The fruits were immersed in liquid nitrogen in 2 min freezing/thawing cycles (one to five). Untreated samples were used as the control. Drying experiments were carried out on treated and non-treated berries at 50 °C and 1 m/s (hot-air-drying), 50 °C and 25″ Hg vacuum (vacuum-drying), 30 mTorr total pressure and 25 °C shelf temperature (freeze-drying). The weight loss evolution of the foodstuffs was measured as a function of time. Microscopic (SEM and optical) determinations of the epicarp were performed. A visual inspection was performed and color changes and volume reductions were assessed before and after dehydration. The thickness of the berries' epicarp decreased between 20 and 50% (depending on the fruit) after 3-5 immersions in liquid N2. The drying kinetics was accelerated significantly for the three tested drying processes (i.e., drying time decreased from 48 to 16 h for blueberry freeze-drying). The best quality of dried berries was observed for pretreated blueberries after freeze-drying, keeping their volume, shape and color after the process. This work shows that "tailor-made" dried berry products with desired properties can be achieved and drying performance can be improved by the application of ultra-low temperature pretreatments.

Orange byproduct (flavedo and albedo) from juice extraction, was used as raw material for this study. Kinetics of total phenolic and total flavonoid contents and antioxidant activity was experimentally determined during both conventional (agitation at 80 rpm) and ultrasound assisted (at 520 and 790 W/L) aqueous extraction from orange byproduct at 5, 15, and 25 °C. An extraction mathematical model was also developed. Significant increase of biocompounds extraction yields was observed as temperature and acoustic power density increased. Ultrasound assistance allowed higher yields at lower temperatures and shorter times. Yields of total phenolic and total flavonoid contents and antioxidant activity obtained with ultrasound extraction (790 W/L, 25 °C, 3 min) were 29%, 39%, and 197% higher, respectively, than those obtained by conventional extraction. The extraction kinetics curves were properly represented by the Weibull model for both conventional and acoustic extraction (mean relative error lower than 5%). Naringin, neohesperidin, and hesperidin were the main phenolic compounds found in the extracts, followed by ferulic, sinapic, and cuomaric acids. Neohesperidin, hesperidin, coumaric acid, and sinapic acid presented the highest yields, especially when extraction was assisted by ultrasound. Meanwhile, naringin and ferulic acid were extracted in a lesser extent, most likely due to their lipophilic character.

Background: Imaging the lower extremity reproducibly and accurately remains an elusive goal. This is particularly true in the high risk diabetic foot, where tissue loss, edema, and color changes are often concomitant. The purpose of this study was to evaluate the reproducibility of a novel and inexpensive stereotaxic frame in assessment of wound healing., Methods: The main idea is to keep constant and reproducible the relative position of extremities related to the sensor used for the examination during a serial studies by stereotaxic digital photographic sequence. Ten healthy volunteers were evaluated at 10 different time moments to estimate the foot position variations in the stereotaxic frame. The evolution of 40 of DFU patients under treatment was evaluated before and during the epidemical grow factor intralesional treatment., Results: The wound closing and granulation speeds, the relative contribution of the contraction and tissue restauration mechanism were evaluated by stereotaxic digital photography., Conclusions: The results of this study suggest that the stereotaxic frame is a robust platform for serial study of the evolution of wound healing which allow to obtain consistent information from a variety of visible and hyperspectral measurement technologies. New stereotaxic digital photography evidences related to the diabetic foot ulcer healing process under treatment has been presented.

Copyright of Redes (1414-7106) is the property of Associacao Pro-Ensino em Santa Cruz do Sul - APESC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to isolate, purify, and characterize a lipase from the gut symbiont Bacillus megaterium F25 (GenBank accession: MF597792) of the aquatic insect Rhantus suturalis, with a focus on its potential applications in biodiesel and food industries. Under optimized culture conditions, B. megaterium F25 could produce 583 U/L of lipase in shaking flask culture. The purified lipase (PL) exhibited a specific activity with 113.89 U/mg, and its molecular weight was determined as 34 kDa. The activity of PL was enhanced by methanol, ethanol, Tween‐80, Triton X‐100, Ca2+, and Mg2+, while β‐mercaptoethanol, EDTA, SDS, Fe2+, Mn2+, and Cu2+ were inhibitory. PL showed optimal activity and stability at neutral and slightly acidic pHs, as well as in a temperature range of 20°C–30°C. PL displayed strong hydrolytic activity toward plant oils and animal fats, indicating its potency for both the food industry and the remediation of oil‐contaminated environments. When tested as a catalyst, PL provided biodiesel production with a transesterification yield of 86.8% under optimized conditions (36 h reaction time, 4 mL enzyme solution, 30°C, pH 7.0, and waste cooking oil:methanol ratio of 10 mL/40 mL). This is the first report on the lipase‐producing potential of gut microbial symbionts of aquatic insects. Furthermore, B. megaterium lipase was tested for the first time as a biocatalyst for biodiesel production. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to analyze the age of breast cancer patients managed with curative approach at the time of treatment with radiotherapy., Background: Breast cancer is the most frequent neoplasm in women. Little is known with regard to the age of patients at diagnosis, and some authors have suggested that breast cancer is now affecting women who are younger than before., Materials and Methods: We performed a descriptive study of our series of breast cancer patients from 1998 to 2011. The age of patients, city of residence, year of treatment and uni- or bilateral location were extracted from the administrative database of the Radiation Oncology Department. The demographical and reference populational data were extracted from the Catalan Institute of Statistics., Results: 3382 patients were obtained. The mean age was 57.79 years. No statistical differences were observed in the mean age during the period of study (p > 0.05), nor in patients with bilateral neoplasias with regard to unilateral tumours (p > 0.5). Patients aged less than 30, 40, 50 and 65 years were 0.3%, 6.3%, 27.0% and 69.1%, respectively. The proportion of patients aged less, equal or more than 40 and 50 years was not statistically different., Conclusions: Breast cancer patients treated with adjuvant radiotherapy after radical surgery have not experienced significant changes in their mean age at treatment. The subgroups of patients that remain out of the mammographic screening programmes were unchanged as well. The observed differences can be explained by demographical disparities and by a probable increase in the indications for adjuvant radiotherapy.

Copyright of Miscelanea Comillas is the property of Universidad Pontificia Comillas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In Europe, approximately 381,500 patients are diagnosed with non-small cell lung cancer (NSCLC) every year. The aim of this study is to analyse the changes in diagnosis, treatment and evolution during the last two decades, using data from a hospital registry., Material and Methods: Patients diagnosed with NSCLC at the Corporació Sanitària Parc Taulí-Sabadell (Catalonia, Spain) during the periods 1990-1997 (n=748) and 2003-2005 (n=311) were included. The hospital tumour registry was used for prospective data collection., Results: Our series shows a significant increase in women diagnosed with NSCLC (6% vs 10.3%; p 0.01) in the latter period; the incidence of adenocarcinomas increased by 20% (31% vs 51.1%), whereas that of squamous cell carcinomas fell (51.3% vs 32.5%; p<0.001). The proportion of patients receiving active treatment also increased significantly, from 56.6% to 76.5% (p<0.001). Disease stage at diagnosis and the number of patients treated by radical surgical resection remained unchanged. Among the favourable independent prognostic factors for survival were: gender (women), age less than 70 years old, Karnofsky index ≥70%, early stage at diagnosis, treatment with chemotherapy, and being diagnosed in the latter period 2003-2005 (HR 0.67). Over this 10-year period, absolute gain in mean survival in our series was 115 days., Conclusions: The absolute gain in mean survival in NSCLC patients in the period studied was 3.8 months, with a 6.75% increase in 5-year survival. Hospital registry data may help the correct assessment of epidemiological changes and the real effectiveness of treatments, which are sometimes overestimated in clinical trials.

Unlabelled: Home enteral nutrition is a treatment carried out frequently due to advantages for patients and caregivers (lower risk of nosocomial infections and better integration in socio-familiar media) but also for the health administration because of the lower economic cost and the release of hospital beds., Objective: To investigate patients' and caregivers' satisfaction related to tube enteral nutrition administered at home by a Service controlled and followed by the Nutritional Support Unit from the reference hospital., Methods: One questionnaire for the patients and another for the caregivers were delivered to the patients with home enteral nutrition asking for voluntary response. Similar questionnaires were sent to hospitalized patients and their relatives or possible caregivers., Results: According to the results of the questionnaires, the majority of patients and relatives were satisfied with the service received. In the cases in which the service was offered at home, the preference was to continue there and not to return to the hospital. Finally, the possibility of telephone contact and home visits were the most important factors that influenced patient satisfaction., Conclusion: Our results let us conclude that home enteral nutrition controlled and followed up by the Nutritional Support Unit form the hospital is a treatment well accepted both by patients and relatives.

Introduction: This study aimed to investigate differences in the three-dimensional (3D) upper airway dimensions in Vietnamese participants. Methods: This study included 341 Vietnamese participants grouped based on the vertical growth pattern (ANB angle) (skeletal Class I, 123; Class II, 124; Class III, 94). The patients were categorized into subgroups based on the horizontal growth pattern according to the Frankfort mandibular angle (hypodivergent, 35; normodivergent, 175; hyperdivergent, 131) to compare the frequency distribution of the three growth patterns in each skeletal class. The airway dimensions of the three skeletal classes were divided into four volumes using 3D virtual software (In VivoDental Software 6.0). The height, width, and cross-sectional area (CSA) of each part, as well as the total volume and minimum CSA, were measured and analyzed. Results: The airway space was reduced in hyperdivergent Class II individuals, underscoring an important connection between upper airway dimensions and vertical skeletal patterns, which suggests that vertical growth patterns contribute to pharyngeal narrowing and subsequent upper airway obstruction. Significant differences (p < 0.001) in the minimum CSAs and volumes of the middle and inferior pharyngeal airways were observed based on Angle's skeletal classification. Conclusions: Our insights are valuable for orthodontics, especially in diverse populations, such as the Vietnamese, due to differences in the influence of genetic and environmental factors on skeletal and airway characteristics. [ABSTRACT FROM AUTHOR]

Root-knot nematodes (RKNs) of the genus Meloidogyne are one of the most damaging genera to cultivated woody plants with a worldwide distribution. The knowledge of the soil and rhizosphere microbiota of almonds infested with Meloidogyne could help to establish new sustainable and efficient management strategies. However, the soil microbiota interaction in deciduous woody plants infected with RKNs is scarcely studied. This research was carried out in six commercial almond groves located in southern Spain and infested with different levels of Meloidogyne spp. within each grove. Several parameters were measured: nematode assemblages, levels and biocontrol agents in Meloidogyne 's eggs, levels of specific biocontrol agents in rhizoplane and soil, levels of bacteria and fungi in rhizoplane and soil, fungal and bacterial communities by high-throughput sequencing of internal transcribed spacer (ITS), and 16S rRNA gene in soil and rhizosphere of the susceptible almond hybrid rootstock GF-677 infested with Meloidogyne spp. The studied almond groves showed soil degradation by nematode assemblies and fungi:bacterial ratio. Fungal parasites of Meloidogyne eggs were found in 56.25% of the samples. However, the percentage of parasitized eggs by fungi ranged from 1% to 8%. Three fungal species were isolated from Meloidogyne eggs, specifically Pochonia chlamydosporia , Purpureocillium lilacinum , and Trichoderma asperellum. The diversity and composition of the microbial communities were more affected by the sample type (soil vs rhizosphere) and by the geographical location of the samples than by the Meloidogyne density, which could be explained by the vigorous hybrid rootstock GF-677 and a possible dilution effect. However, the saprotrophic function in the functional guilds of the fungal ASV was increased in the highly infected roots vs the low infected roots. These results indicate that the presence of biocontrol agents in almond fields and the development of new management strategies could increase their populations to control partially RKN infection levels. [ABSTRACT FROM AUTHOR]

Simple Summary: This study raises the question whether all breast cancer patients need axillary lymph node dissection (ALND) after neoadjuvant chemotherapy (NAC). Researchers assessed a novel clinical variable: the sentinel lymph node ratio (SLN-R) to predict additional cancerous lymph nodes during ALND. SLN-R was defined as total number of positive sentinel nodes among all sentinel nodes removed during axillary staging after NAC. Axillary surgery included Targeted Axillary Dissection (TAD) technique for cN1 breast cancer patients. We analyzed data from 1521 patients, focusing on 118 with specific cancer stages and positive sentinel /TAD nodes results after NAC. The results indicated that an SLN-R value below 0.35 could suggest a lower chance of finding more cancerous nodes, with a 10.2% false-negative rate. This means SLN-R could help identify patients who might avoid unnecessary surgeries. By combining SLN-R with other clinical factors, the study aims to create a predictive tool, enhancing personalized care and improving patients' quality of life. Background/Objectives: The aim of the study was to determine the clinical value of the sentinel lymph node ratio (SLN-R) in predicting additional positive lymph nodes during axillary lymph node dissection (ALND) in breast cancer patients following neoadjuvant chemotherapy (NAC). Methods: A cross-sectional study was performed at a single institution evaluating data from 1521 BC patients. Inclusion criteria comprised cT1/cT4, cN0/cN1 status with positive post-NAC axillary staging by SLN/TAD, respectively, and subsequent ALND. Results: The study included 118 patients, divided into two groups based on the presence or absence of additional node metastasis at ALND: 39 in the residual disease group (RD) and 79 in the non-residual disease group (nRD). Univariate logistic regression analysis of SLN-R was conducted to assess its predictive value, yielding an odds ratio (OR) of 7.79 (CI 1.92–29.5, p = 0.003). An SLN-R cut-off point of <0.35 was identified using ROC curve analysis, with a false-negative rate of 10.2%, as a predictor for no additional metastasis at ALND following post-NAC SLN/TAD positivity. Conclusions: The study concludes that SLN-R is a valuable predictor for determining the omission of ALND in cases where SLN/TAD is positive after NAC. This metric, in combination with other clinical variables, could help develop a nomogram to spare patients from ALND. [ABSTRACT FROM AUTHOR]

Two screening and one resistance verification trial involving 20 Prunus rootstocks were conducted under greenhouse conditions against Meloidogyne spp. and Pratylenchus vulnus. Most of the rootstocks were experimental genotypes or new commercial peach and plums of Spanish and French origin. Nearly all are interspecific hybrid rootstocks. In the first trial, the rootstocks Bruce, Cadaman, Mirac, G x N No. 15, Cachirulo x (G x N No. 9), and P. myra x peach were immune or resistant to a mixture of seven isolates of M. incognita. In the second screening trial, the hybrid plum P 2588 was a poor host to a mixture of four isolates of P. vulnus. The remaining seven rootstocks were good hosts to the root-lesion nematode. In the resistance verification trial GF-31, G x N No. 15, Torinel, AD- l 01, Monpol, Nemaguard, and Cadaman maintained a high level of resistance when tested against a mixture of 17 isolates comprising M. incognita, M. javanica, M. arenaria, M. hapla, and M. hispanica. Barrier peach suffered a partial loss of resistance not detected in previous tests.

Background: The distant metastasis of lung cancer primarily occurs in the bones, liver, brain, and lungs, while the breast is an extremely rare site of metastasis. There is very limited literature on the occurrence of breast metastasis from lung cancer, and metastatic lesions in the breast are prone to being misdiagnosed as primary breast cancer, requiring careful attention and differentiation in the clinical diagnostic and treatment process. Case summary: The patient, a 63-year-old female, initially presented with an EGFR exon 21 L858R mutated left lung adenocarcinoma in 2017, treated successfully with surgical resection and subsequent monitoring. The relapse of disease occurred in January 2020. Despite maintaining a prolonged progression-free survival (PFS) with first-generation EGFR-TKI Afatinib, disease progression occurred in 2022 without detectable resistance mutations. Transition to second-generation TKI Furmonertinib resulted in poor control, with rapid progression including unusual bilateral breast metastases that exhibited inflammatory breast cancer-like peau d'orange changes. Standard chemotherapy achieved only short-term stability. Upon detecting a MET amplification mutation, treatment with Savolitinib was initiated. Remarkably, this led to significant clinical and radiographic improvement, notably resolving the peau d'orange appearance and reducing multiple lesions across the body. Conclusion: This case underscores the importance of continuous genetic profiling and tailored treatment approaches in managing advanced lung adenocarcinoma, particularly when presenting with rare metastatic sites and complex genetic landscapes. The successful application of Savolitinib following the identification of a MET amplification mutation highlights its potential in overcoming resistance mechanisms in NSCLC, providing a significant therapeutic option for similarly challenging cases. [ABSTRACT FROM AUTHOR]

Omega-3 fatty acids are essential fatty acids that are not synthesised by the human body and have been linked with the prevention of chronic illnesses such as cardiovascular and neurodegenerative diseases. However, the current dietary habits of the majority of the population include lower omega-3 content compared to omega-6, which does not promote good health. To overcome this, pharmaceutical and nutraceutical companies aim to produce omega-3-fortified foods. For this purpose, various approaches have been employed to obtain omega-3 concentrates from sources such as fish and algal oil with higher amounts of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Among these techniques, enzymatic enrichment using lipase enzymes has gained tremendous interest as it is low in capital cost and simple in operation. Microorganism-derived lipases are preferred as they are easily produced due to their higher growth rate, and they hold the ability to be manipulated using genetic modification. This review aims to highlight the recent studies that have been carried out using marine lipases for the enrichment of omega-3, to provide insight into future directions. Overall, the covalent bond-based lipase immobilization to various support materials appears most promising; however, greener and less expensive options need to be strengthened. [ABSTRACT FROM AUTHOR]

Snake gourd is a seasonal vegetable with a high water content and medicinal value, but the short harvest period limits the large-scale application of snake gourd. Therefore, the effects of freeze–thaw pretreatment (FT) combined with hot air (HD) on the drying characteristics, active ingredients and bioactivities of snake gourd were investigated. The results showed that FT pretreatment reduced browning and shortened the drying time by 44%; the Page model was the best fit for describing the drying process. The polysaccharide contents (21.70% in alcoholic extract (TG1) and 44.34% in water extract (TG2)) and total phenol contents (1.81% in TG1 and 0.88% in TG2) of snake gourd pretreated by FT-HD were higher than those of snake gourd pretreated by the corresponding HD treatment. The FT pretreatment decreased the molecular weight of snake gourd polysaccharides and increased the molar ratio of glucose. The extracts pretreated by FT-HD showed greater chemical, cellular antioxidant capacity and α-amylase and α-glucosidase inhibition than those pretreated by HD. FT-HD can be recommended for achieving a short drying time and high quality of snake gourd and can be used for the drying of other fruits and vegetables. [ABSTRACT FROM AUTHOR]

Background: The addition of pertuzumab (P) to trastuzumab (H) and standard chemotherapy (CT) as neoadjuvant treatment (NaT) for patients with HER2 + breast cancer (BC), has shown to increase the pathological complete response (pCR) rate, without main safety concerns. The aim of NeoPowER trial is to evaluate safety and efficacy of P + H + CT in a real–world population. Methods: We retrospectively reviewed the medical records of stage II–III, HER2 + BC patients treated with NaT: who received P + H + CT (neopower group) in 5 Emilia Romagna institutions were compared with an historical group who received H + CT (control group). The primary endpoint was the safety, secondary endpoints were pCR rate, DRFS and OS and their correlation to NaT and other potential variables. Results: 260 patients were included, 48% received P + H + CT, of whom 44% was given anthraciclynes as part of CT, compared to 83% in the control group. The toxicity profile was similar, excluding diarrhea more frequent in the neopower group (20% vs. 9%). Three patients experienced significant reductions in left ventricular ejection fraction (LVEF), all receiving anthracyclines. The pCR rate was 46% (P + H + CT) and 40% (H + CT) (p = 0.39). The addition of P had statistically correlation with pCR only in the patients receiving anthra-free regimens (OR = 3.05,p = 0.047). Preoperative use of anthracyclines (OR = 1.81,p = 0.03) and duration of NaT (OR = 1.18,p = 0.02) were statistically related to pCR. 12/21 distant-relapse events and 14/17 deaths occurred in the control group. Patients who achieve pCR had a significant increase in DRFS (HR = 0.23,p = 0.009). Conclusions: Adding neoadjuvant P to H and CT is safe. With the exception of diarrhea, rate of adverse events of grade > 2 did not differ between the two groups. P did not increase the cardiotoxicity when added to H + CT, nevertheless in our population all cardiac events occurred in patients who received anthracycline-containing regimens. Not statistically significant, higher pCR rate is achievable in patients receiving neoadjuvant P + H + CT. The study did not show a statistically significant correlation between the addition of P and long-term outcomes. [ABSTRACT FROM AUTHOR]

The citrus processing industry is responsible for the generation of large volumes of waste side streams, represented principally by fruit peels. These tissues are exceptionally rich in polyphenolic bioactive phytochemicals, and there has been a great industrial interest for their valorization. The examination presented herein targeted at developing a fast and straight-forward aqueous extraction process, based on ultrasonication, for the efficacious recovery of polyphenolic compounds from waste orange peels. After an initial single-factor examination, the response surface optimization showed that a maximum total polyphenol yield of 12.81 mg chlorogenic acid equivalents (GAE) per g−1 dry mass could be achieved by setting sonicator amplitude at 80%, for 15 min, using a duty cycle of 2/2 (2 s on/2 s off). Comparison of this methodology with a stirred-tank extraction demonstrated that the ultrasonication technique was equally effective, requiring ambient temperature and considerably shorter resident time. The combination of both techniques using the ultrasonication process as a pretreatment step did not boost extraction yield, and the extracts produced had similar polyphenolic composition and antioxidant activity. However, a slight enhancement of the recovery of individual constituents was noted. It is proposed that efficient extraction of polyphenolic substances from waste orange peels may be accomplished using the present methodology, which is a low-cost (ambient temperature, short time) and sustainable (water as solvent) process. [ABSTRACT FROM AUTHOR]

Simple Summary: Recent advances in cancer therapy have spotlighted immune checkpoint inhibitors (ICIs) as a breakthrough in treating various cancers. These treatments, however, can lead to immune-related adverse events (irAEs) that mirror the body's heightened immune response, affecting multiple organs. Recognizing and managing these irAEs is critical, and imaging modalities such as 18F-FDG PET/CT have emerged as a potential tool for early detection. This review delves into the capability of 18F-FDG PET/CT to identify irAEs, exploring the patterns of metabolic activation indicative of these events. While highlighting the current utility of PET/CT scans in oncology for tracking therapy response and irAEs, the review also speculates on future directions, suggesting a potential role in refining immunotherapy strategies and enhancing patient care. The insights obtained could transform patient monitoring during ICI therapy, potentially improving outcomes by facilitating prompt management of irAEs. Immunotherapy with immune checkpoint inhibitors (ICIs) has revolutionized contemporary oncology, presenting efficacy in various solid tumors and lymphomas. However, ICIs may potentially overstimulate the immune system, leading to immune-related adverse events (irAEs). IrAEs may affect multiple organs, such as the colon, stomach, small intestine, kidneys, skin, lungs, joints, liver, lymph nodes, bone marrow, brain, heart, and endocrine glands (e.g., pancreas, thyroid, or adrenal glands), exhibiting autoimmune inflammation. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is commonly used in oncology for staging and assessment of therapy responses, but it may also serve as a tool for detecting irAEs. This review aims to present various patterns of metabolic activation associated with irAEs due to ICI treatment, identifiable through 18F-FDG PET/CT. It describes the advantages of early detection of irAEs, but also presents the challenges in differentiating them from tumor progression. It also delves into aspects of molecular response assessment within the context of pseudoprogression and hyperprogression, along with typical imaging findings related to these phenomena. Lastly, it summarizes the role of functional PET imaging in oncological immunotherapy, speculating on its future significance and limitations. [ABSTRACT FROM AUTHOR]

Combining epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with an anti‐ vascular endothelial growth factor (VEGF) agent, bevacizumab or ramucirumab, is indicated for advanced lung adenocarcinoma harboring EGFR mutation. This study aimed to show the real‐world data of combination therapy and compare the effectiveness between bevacizumab and ramucirumab in combination with an EGFR‐TKI. This retrospective study enrolled 47 patients diagnosed of stage IV lung adenocarcinoma with exon 19 deletion or L858R point mutation, receiving a first‐line EGFR‐TKI with anti‐VEGF agent, including 34 (72%) and 13 (28%) patients receiving bevacizumab and ramucirumab, respectively. The response rate was similar in both groups (p = 0.38). Patients receiving bevacizumab had similar progression free survival (PFS) as those receiving ramucirumab (median PFS: 21.9 vs. 24.2 months, p = 0.4871); similar finding was noted in overall survival (OS) (median OS: 33.5 months vs. not reached, p = 0.4618). Patients receiving ramucirumab experienced a significantly high‐grade hypertension compared to those receiving bevacizumab (p = 0.0351). Multivariable Cox regression analysis found independent risk factors for worse PFS included poorer ECOG performance status, multiple (≥3) metastatic sites, brain metastasis, and pleural metastasis/effusion, while the type of anti‐VEGF agent was not a risk factor. Pericardial metastasis/effusion was the only one independent risk factor for worse OS. In summary, ramucirumab may have similar effectiveness as bevacizumab in combination with an EGFR‐TKI as first line therapy for advanced lung adenocarcinoma harboring susceptible EGFR mutation. Further large‐scale registry‐based cohort studies may be needed to validate our findings. [ABSTRACT FROM AUTHOR]

Introduction: Real-world studies on neoadjuvant dual anti-HER2 therapy combined with chemotherapy for breast cancer (BC) are scarce in China. This study aimed to evaluate the efficacy and safety of neoadjuvant dual anti-HER2 therapy combined with chemotherapy in a real-world setting. Moreover, differences in estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and proliferation cell nuclear antigen (Ki-67) expression pre- and post-neoadjuvant therapy were analyzed. Methods: Clinical and pathological data of patients with HER2-positive BC who received neoadjuvant dual anti-HER2 therapy combined with chemotherapy at Liaoning Cancer Hospital & Institute, China, between September 2021 and September 2023, were retrospectively reviewed. Results: Among 179 included patients, a pathologic complete response (pCR) was achieved in 109 patients (60.9%). The univariate analysis results indicated that the hormone receptor (HR) status (P = 0.013), HER2 status (P = 0.003), and cycles of targeted treatment (P = 0.035) were significantly correlated with pCR. Subsequent multivariable analysis showed that HR negative and HER2 status 3 + were independent predictive factors of pCR. Anemia was the most common adverse event (62.0%), and the most common grade 3–4 adverse event was neutropenia (6.1%). The differences in HER2 (34.5%) and Ki-67 (92.7%) expression between core needle biopsy and the residual tumor after neoadjuvant therapy were statistically significant, whereas the differences were insignificant in terms of ER or PR status. Conclusions: The combination of neoadjuvant trastuzumab and pertuzumab with chemotherapy showed good efficiency, and the toxic side effects were tolerable in patients with BC. In cases where pCR was not achieved after neoadjuvant therapy, downregulation of HER2 and Ki-67 expressions was observed. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Duodenal GISTs are rare and challenging tumors. Acute life‐threatening upper GI bleeding is a possible presentation of duodenal GISTs. Surgery is the standard treatment for localized duodenal GISTs. Imatinib is an effective adjuvant therapy for duodenal GISTs. GIST is the most common mesenchymal neoplasm of the gastrointestinal tract, accounting for 1%–2% of gastrointestinal tumors. They originate from the interstitial cells of Cajal and are rare in patients younger than 30 years. The stomach is the most common site, followed by the small intestine and colon. GISTs are caused by a gain‐of‐function mutation in the proto‐oncogene receptor tyrosine kinase, with activating mutations in KIT being the most common. Most GISTs are asymptomatic. Even if gastrointestinal bleeding is the most common complication life‐threatening hemorrhage is extremely uncommon. We present a case of a 31‐year‐old male patient presented with massive active hematemesis and melena with hemorrhagic shock. The patient presented with massive hematemesis and melena of 1 h duration. Endoscopy showed pulsating active bleeding from the third part of the duodenum which was difficult to manage via endoscopy. Histopathologic evaluation showed spindle cell type GIST. Intraoperatively, there was a nodular mass with active bleeding on the third part of the duodenum. Duodenectomy with end‐to‐end anastomosis was done. Discharged with no postoperative complication and was put on imatinib. There are considerable challenges that arise in the diagnosis and treatment of duodenal gastrointestinal stromal tumors (GISTs) when they present with life‐threatening upper gastrointestinal hemorrhage. In order to achieve the best possible outcomes for patients, it is crucial to have a comprehensive understanding of the clinical presentation, diagnostic methods, and treatment approaches. [ABSTRACT FROM AUTHOR]

This work evaluated the green extraction of oleoresin from pink pepper fruits (ORPPF) using ultrasound-assisted extraction (UAE) and ethanol as a solvent. The effects of temperature, ultrasound power intensity, sample to solvent ratio and time on the global extraction yield (YGE) and phenolic compounds yield (YPC) were evaluated. The oleoresin samples were characterized and its antimicrobial activity determined, and the obtained results were compared to conventional extraction in Soxhlet. From the results it was found that the application of the highest levels of the independent variables favored the extraction process. The maximum values of YGE and YPC were 28.60 wt% and 6.37 mg GAE per g fruit, respectively, obtained at 60 °C, 100% of ultrasound power (165 W), 1:20 g mL−1 (sample:solvent) and 45 min. Under maximized conditions, the ORPPF obtained by UAE showed a content of phenolic compounds and antioxidant activity inferior to soxhlet–ethanol extraction. However, the time and solvent consumption were reduced. Oleic and linoleic acids predominated in the fatty acid composition of ORPPF, in addition to sesquiterpenes and gallic and syringic acids. The ORPPF presented weak antibacterial activity, with minimum inhibitory concentration ranging from 31.25 to 125 mg mL−1. [ABSTRACT FROM AUTHOR]