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Ice cream is a frozen dessert highly appreciated by all categories of consumers. Lately, consumers' attention is focused on healthy products, with as few ingredients as possible or with natural ingredients. By definition, ice cream is a sweet product. As a rule, sugar is used to obtain ice cream for its characteristics (sweet taste, creaminess, texture, melting time), but the new requirements require the addition or substitution of sugar with other sweeteners. Consumers still prefer the sweet taste of artificial sweeteners, but they are cultivating their taste and increasingly choosing natural nutritious or non-nutritive sweeteners as consumer awareness of healthy foods has increased. This manuscript was based on the study of the literature regarding the use of natural sweeteners in ice cream formulations.

Frozen dough technology is widely used and may guarantee bread's freshness and so prolong its shelf life. However, a variety of issues, including the restriction of yeast activity and structural damage to the dough, may arise while frozen dough is being made and store, ultimately resulting in a loss of quality. After fermentation, the bread's ability to retain CO2 and the yeast's ability to produce CO2 determine the frozen dough's quality. Ice crystals are thought to be the primary cause of both decreased viability of yeast and the breakdown of the dough network structure, which two significant elements are contributing to the decline in dough quality. Several factors affect yeast's resistance to freezing and thawing, such as its physiological state before freezing; for instance, yeast cells in growth standstill are more resistant to freezing than those in the exponential growth phase. Numerous strategies and methods have been created to raise the freezing baker's yeast resistance and, consequently, the quality of frozen dough. These strategies include the use of genetic engineering, the incorporation of chemicals like hydrocolloids and antifreeze proteins (AFP), the improvement of freezing times and circumstances of storage, and the creation of novel freezing techniques like ultrasonic freezing. These techniques for enhancing the freezing resistance of baker's yeast are outlined in the publication.

Abstract Vibrio parahaemolyticus, Vibrio vulnificus and non‐O1/non‐O139 Vibrio cholerae are the Vibrio spp. of highest relevance for public health in the EU through seafood consumption. Infection with V. parahaemolyticus is associated with the haemolysins thermostable direct haemolysin (TDH) and TDH‐related haemolysin (TRH) and mainly leads to acute gastroenteritis. V. vulnificus infections can lead to sepsis and death in susceptible individuals. V. cholerae non‐O1/non‐O139 can cause mild gastroenteritis or lead to severe infections, including sepsis, in susceptible individuals. The pooled prevalence estimate in seafood is 19.6% (95% CI 13.7–27.4), 6.1% (95% CI 3.0–11.8) and 4.1% (95% CI 2.4–6.9) for V. parahaemolyticus, V. vulnificus and non‐choleragenic V. cholerae, respectively. Approximately one out of five V. parahaemolyticus‐positive samples contain pathogenic strains. A large spectrum of antimicrobial resistances, some of which are intrinsic, has been found in vibrios isolated from seafood or food‐borne infections in Europe. Genes conferring resistance to medically important antimicrobials and associated with mobile genetic elements are increasingly detected in vibrios. Temperature and salinity are the most relevant drivers for Vibrio abundance in the aquatic environment. It is anticipated that the occurrence and levels of the relevant Vibrio spp. in seafood will increase in response to coastal warming and extreme weather events, especially in low‐salinity/brackish waters. While some measures, like high‐pressure processing, irradiation or depuration reduce the levels of Vibrio spp. in seafood, maintaining the cold chain is important to prevent their growth. Available risk assessments addressed V. parahaemolyticus in various types of seafood and V. vulnificus in raw oysters and octopus. A quantitative microbiological risk assessment relevant in an EU context would be V. parahaemolyticus in bivalve molluscs (oysters), evaluating the effect of mitigations, especially in a climate change scenario. Knowledge gaps related to Vibrio spp. in seafood and aquatic environments are identified and future research needs are prioritised.

Wine lees, the second most significant by-product of winemaking after grape pomace, have received relatively little attention regarding their potential for valorization. Despite their rich content in bioactive components such as β-glucans, industrial utilization faces challenges, particularly due to variability in their composition. This inconsistency impacts the reliability and standardization of final products, limiting broader adoption in industrial applications. β-Glucans are dietary fibers or polysaccharides renowned for their diverse bioactive properties, including immunomodulatory, antioxidant, anti-inflammatory, antitumor, and cholesterol- and glucose-lowering effects. They modulate the immune system by activating Dectin-1 and TLR receptors on immune cells, enhancing phagocytosis, cytokine production, and adaptive immune responses. Their antioxidant activity arises from neutralizing free radicals and reducing oxidative stress, thereby protecting cells and tissues. β-Glucans also exhibit antitumor effects by inhibiting cancer cell growth, inducing apoptosis, and preventing angiogenesis, the formation of new blood vessels essential for tumor development. Additionally, they lower cholesterol and glucose levels by forming a viscous gel in the intestine, which reduces lipid and carbohydrate absorption, improving metabolic health. The biological activity of β-glucans varies with their molecular weight and source, further highlighting their versatility and functional potential. This study investigates how grape variety, vinification technology and extraction methods affect the yield and properties of β-glucans extracted from wine lees. The physico-chemical and mineral composition of different wine lees were analyzed, and two extraction methods of β-glucans from wine lees were tested: acid-base extraction and autolysis. These two methods were also tested under ultrasound-assisted conditions at different frequencies, as well as without the use of ultrasound. The β-glucan yield and properties were evaluated under different conditions. FTIR spectroscopy was used to assess the functional groups and structural characteristics of the β-glucans extracted from the wine lees, helping to confirm their composition and quality. Rheological behavior of the extracted β-glucans was also assessed to understand the impact of extraction method and raw material origin. The findings highlight that vinification technology significantly affects the composition of wine lees, while both the extraction method and yeast origin influence the yield and type of β-glucans obtained. The autolysis method provided higher β-glucan yields (18.95 ± 0.49% to 39.36 ± 0.19%) compared to the acid–base method (3.47 ± 0.66% to 19.76 ± 0.58%). FTIR spectroscopy revealed that the β-glucan extracts contain a variety of glucan and polysaccharide types, with distinct β-glucans (β-1,4, β-1,3, and β-1,6) identified through specific absorption peaks. The rheological behavior of suspensions exhibited pseudoplastic or shear-thinning behavior, where viscosity decreased significantly as shear rate increased. This behavior, observed across all β-glucan extracts, is typical of polymer-containing suspensions. These insights are critical for optimizing β-glucan extraction processes, supporting sustainability efforts and waste valorization in the wine industry. Efficient extraction of β-glucans from natural sources like wine lees offers a promising path toward their industrial application as valuable functional compounds.

Radon (Rn 222) is a significant contributor to natural radiation exposure in residential environments such as single-family houses and multistory buildings. This study monitored radon activity concentration (RAC) in 455 apartments in 30 multistory buildings in Buzău, Romania. Integrated measurements of the RAC using CR-39 nuclear track detectors were conducted for a period of 3 to 4 months. The results revealed that the RAC varies between buildings, with an annual average between 33 and 77 Bq/m3. This variation may be attributed to poor ventilation and the chimney effect in common ventilation ducts, which may facilitate radon displacement vertically. Also, apartments with low occupancy or inadequate ventilation showed higher radon levels of up to 285 Bq/m3. The study highlights the potential risk of increased radon exposure in energy-efficient buildings due to poor ventilation, emphasizing the need for special attention to radon mitigation measures in building design. The results emphasize that the RAC is influenced by building characteristics, room use, and ventilation, with significant implications for health risks in urban residential environments.

As the whisky industry applies circular economy principles to maximize resource utilization and minimize environmental impact, companies become exposed to several risks, which require complex assessments to ensure reliable outcomes. This study provides an organized framework to identify, prioritize, and rank various risk factors commonly observed in the whisky industry through the development of an analytical hierarchy process (AHP) multi-criteria analysis model. Experts from 18 small European distilleries identified five main risk criteria and nineteen sub-criteria from brainstorming workplace observations and categorized them as: environmental (5), operational (4), technological innovation (3), food safety (3), and economical (4) risks. The analytical hierarchy process (AHP) approach was used to determine the weights and ranks of the main criteria and sub-criteria based on the survey responses received from experts from each distillery. The final judgements are consistent, as indicated by consistency values (CR) of less than 0.1 for all risk criteria. Unlike traditional risk assessment methods, the AHP model effectively integrates qualitative and quantitative data, aiding strategic decision making in the whisky industry by breaking down complex problems into manageable sub-problems. Future research directions may expand the criteria and explore additional sustainable practices.

In the sensory analysis of the food and beverage industry, the use of advanced decision-making procedures like the Analytical Hierarchy Process (AHP) is yet largely unexplored. Analytical Hierarchy Process (AHP) is a decision-making tool that reflects human thinking, breaking down complex decisions into one-to-one comparisons. The AHP method enhances sensory analysis precision by reducing expert variability and allowing quick removal and retraining of tasters who deviate significantly from the group. Consumer demand for diverse beverages has led to exploring alternative raw materials in beer production, with buckwheat and sorghum being notable due to their nutritional and gluten-free qualities. The paper explores how AHP, a decision-making tool, can enhance sensory analysis for buckwheat and sorghum beers through pair wise comparisons, revealing subtle sensory profiles.

n the process of obtaining gluten-free beer, various non-conventional raw materials were used. Some of these have shown real potential in obtaining quality finished products appreciated by consumers. In addition to health issues, several factors also play a role in the choice of these raw materials, one of which is the climate changes that are occurring around the globe. The paper summarizes our own research on the use of two of these non-conventional materials, buckwheat and sorghum, in unmalted form in the technological process of obtaining beer at microbrewery equipment. Through the research carried out, it was aimed to establish optimal conditions for mashing-saccharification and fermentation-aging processes that would lead to a quality finished product. The best results in terms of sensory and physico-chemical characteristics were achieved by beer obtained from 50 % unmalted buckwheat and 50 % unmalted sorghum.

Abstract Background Milk thistle is one of the most popular hepatoprotectants, and is often sold in combination with other ingredients. Botanical supplements are known to be vulnerable to contamination and adulteration, and emerging technologies show promise to improve their quality control. Methods Untargeted and semi-targeted metabolomics based on UHPLC-QTOF-ESI+MS techniques, UV spectrometry, and DNA metabarcoding using Illumina MiSeq were used to authenticate eighteen milk thistle botanical formulations (teas, capsules, tablets, emulsion). Results Untargeted metabolomics separated 217 molecules and by multivariate analysis the discrimination between the different preparations was established. The semi-targeted metabolomics focused on 63 phytochemicals, mainly silymarin flavonolignans and flavonoids, that may be considered as putative biomarkers of authenticity. All formulations contained molecules from silymarin complexes at different levels. The quantitative evaluation of silybins was done using in parallel UV spectrometry and UHPLC-QTOF-ESI+MS and their correlations were compared. DNA metabarcoding detected milk thistle in eleven out of sixteen retained preparations, whereas two others had incomplete evidence of milk thistle despite metabolomics validating specific metabolites, e.g., silymarin complex, identified and quantified in all samples. Meanwhile, the DNA metabarcoding provided insights into the total species composition allowing the interpretation of the results in a broad context. Conclusion Our study emphasizes that combining spectroscopic, chromatographic, and genetic techniques bring complementary information to guarantee the quality of the botanical formulations.

Abstract Background Interactive videogames, virtual reality, and robotics represent a new opportunity for multimodal treatments in many rehabilitation contexts. However, several commercial videogames are designed for leisure and are not oriented toward definite rehabilitation goals. Among the many, Playball® (Playwork, Alon 10, Ness Ziona, Israel) is a therapeutic ball that measures both movement and pressure applied on it while performing rehabilitation games. This study aimed: (i) to evaluate whether the use of this novel digital therapy gaming system was clinically effective during shoulder rehabilitation; (ii) to understand whether this gaming rehabilitation program was effective in improving patients’ engagement (perceived enjoyment and self-efficacy during therapy; attitude and intention to train at home) in comparison to a control non-gaming rehabilitation program. Methods A randomized controlled experimental design was outlined. Twenty-two adults with shoulder pathologies were recruited for a rehabilitation program of ten consecutive sessions. A control (CTRL; N = 11; age: 62.0 ± 10.9 yrs) and an intervention group (PG; N = 11; age: 59.9 ± 10.2 yrs) followed a non-digital and a digital therapy, respectively. The day before (T0) and after (T1) the rehabilitation program, pain, strength, and mobility assessments were performed, together with six questionnaires: PENN shoulder Score, PACES-short, Self-efficacy, Attitudes to train at home, Intention to train at home, and System usability scale (SUS). Results MANOVA analysis showed significant improvements in pain (p

Abstract Listeria monocytogenes (in the meat, fish and seafood, dairy and fruit and vegetable sectors), Salmonella enterica (in the feed, meat, egg and low moisture food sectors) and Cronobacter sakazakii (in the low moisture food sector) were identified as the bacterial food safety hazards most relevant to public health that are associated with persistence in the food and feed processing environment (FFPE). There is a wide range of subtypes of these hazards involved in persistence in the FFPE. While some specific subtypes are more commonly reported as persistent, it is currently not possible to identify universal markers (i.e. genetic determinants) for this trait. Common risk factors for persistence in the FFPE are inadequate zoning and hygiene barriers; lack of hygienic design of equipment and machines; and inadequate cleaning and disinfection. A well‐designed environmental sampling and testing programme is the most effective strategy to identify contamination sources and detect potentially persistent hazards. The establishment of hygienic barriers and measures within the food safety management system, during implementation of hazard analysis and critical control points, is key to prevent and/or control bacterial persistence in the FFPE. Once persistence is suspected in a plant, a ‘seek‐and‐destroy’ approach is frequently recommended, including intensified monitoring, the introduction of control measures and the continuation of the intensified monitoring. Successful actions triggered by persistence of L. monocytogenes are described, as well as interventions with direct bactericidal activity. These interventions could be efficient if properly validated, correctly applied and verified under industrial conditions. Perspectives are provided for performing a risk assessment for relevant combinations of hazard and food sector to assess the relative public health risk that can be associated with persistence, based on bottom‐up and top‐down approaches. Knowledge gaps related to bacterial food safety hazards associated with persistence in the FFPE and priorities for future research are provided.

Traditional Chinese Medicine (TCM) is popular for the treatment of endometriosis, a complex gynecological disease that affects 10% of women globally. The growing market for TCMs has yielded a significant incentive for product adulteration, and although emerging technologies show promise to improve their quality control, many challenges remain. We tested the authenticity of two traditional Chinese herbal formulae used in women’s healthcare for the treatment of endometriosis, known as Gui Zhi Fu Ling Wan (FL) and Ge Xia Zhu Yu Tang (GX). Dual-locus DNA metabarcoding analysis coupled with high-performance thin-layer chromatography (HPTLC) were used to authenticate 19 FL and six GX commercial herbal products, as well as three ad hoc prepared artificial mixtures. HPTLC was able to detect most of the expected ingredients via comparative component analysis. DNA metabarcoding was able to detect an unexpected species diversity in the products, including 38 unexpected taxa. Chromatography has a resolution for all species indirectly through the identification of marker compounds for the different species ingredients. Metabarcoding on the other hand yields an overview of species diversity in each sample, but interpretation of the results can be challenging. Detected species might not be present in quantities that matter, and without validated quantification, some detected species can be hard to interpret. Comparative analysis of the two analytical approaches also reveals that DNA for species might be absent or too fragmented to amplify as the relevant chemical marker compounds can be detected but no amplicons are assigned to the same species. Our study emphasizes that integrating DNA metabarcoding with phytochemical analysis brings valuable data for the comprehensive authentication of Traditional Chinese Medicines ensuring their quality and safe use.

IntroductionConnected landscapes can increase the effectiveness of protected areas by facilitating individual movement and gene flow between populations, thereby increasing the persistence of species even in fragmented habitats. Connectivity planning is often based on modeling connectivity for a limited number of species, i.e., “connectivity umbrellas”, which serve as surrogates for co-occurring species. Connectivity umbrellas are usually selected a priori, based on a few life history traits and often without evaluating other species.MethodsWe developed a quantitative method to identify connectivity umbrellas at multiple scales. We demonstrate the approach on the terrestrial large mammal community (24 species) in continental Europe at two scales: 13 geographic biomes and 36 ecoregions, and evaluate the interaction of landscape characteristics on the selection of connectivity umbrellas.ResultsWe show that the number, identity, and attributes of connectivity umbrellas are sensitive to spatial scale and human influence on the landscape. Multiple species were selected as connectivity umbrellas in 92% of the geographic biomes (average of 4.15 species) and 83% of the ecoregions (average of 3.16 species). None of the 24 species evaluated is by itself an effective connectivity umbrella across its entire range. We identified significant interactions between species and landscape attributes. Species selected as connectivity umbrellas in regions with low human influence have higher mean body mass, larger home ranges, longer dispersal distances, smaller geographic ranges, occur at lower population densities, and are of higher conservation concern than connectivity umbrellas in more human-influenced regions. More species are required to meet connectivity targets in regions with high human influence (average of three species) in comparison to regions with low human influence (average of 1.67 species).DiscussionWe conclude that multiple species selected in relation to landscape scale and characteristics are essential to meet connectivity goals. Our approach enhances objectivity in selecting which and how many species are required for connectivity conservation and fosters well-informed decisions, that in turn benefit entire communities and ecosystems.

Abstract An assessment was conducted on the level of inactivation of relevant pathogens that could be present in processed animal protein of porcine origin intended to feed poultry and aquaculture animals when methods 2 to 5 and method 7, as detailed in Regulation (EU) No 142/2011, are applied. Five approved scenarios were selected for method 7. Salmonella Senftenberg, Enterococcus faecalis, spores of Clostridium perfringens and parvoviruses were shortlisted as target indicators. Inactivation parameters for these indicators were extracted from extensive literature search and a recent EFSA scientific opinion. An adapted Bigelow model was fitted to retrieved data to estimate the probability that methods 2 to 5, in coincidental and consecutive modes, and the five scenarios of method 7 are able to achieve a 5 log10 and a 3 log10 reduction of bacterial indicators and parvoviruses, respectively. Spores of C. perfringens were the indicator with the lowest probability of achieving the target reduction by methods 2 to 5, in coincidental and consecutive mode, and by the five considered scenarios of method 7. An expert knowledge elicitation was conducted to estimate the certainty of achieving a 5 log10 reduction of spores of C. perfringens considering the results of the model and additional evidence. A 5 log10 reduction of C. perfringens spores was judged: 99–100% certain for methods 2 and 3 in coincidental mode; 98–100% certain for method 7 scenario 3; 80–99% certain for method 5 in coincidental mode; 66–100% certain for method 4 in coincidental mode and for method 7 scenarios 4 and 5; 25–75% certain for method 7 scenario 2; and 0–5% certain for method 7 scenario 1. Higher certainty is expected for methods 2 to 5 in consecutive mode compared to coincidental mode.

The food industry generates huge amounts of food by-products annually, most of which are considered waste. But these by-products may contain nutrients of interest and have a low-cost price. Capitalizing on these by-products is of interest to both producers and consumers, thus supporting the circular economy. In this context, the current paper aimed to evaluate the fatty acid profile and the amino acid profile of spent grain from distilleries compared to spent grain coming from the beer industry. The main fatty acids were identified linoleic, palmitic, and oleic acids. Amino acids are necessary for the production of enzymes, hormones, and even some neurotransmitters, being considered the most important nutrients of the human body. The most abundant essential amino acid is valine in both samples analyzed and the lowest level of essential amino acid is tryptophan for distilleries spent grain (DSG) and leucine for brewery spent grain (BSG).

Herbal medicines and preparations are widely used in healthcare systems globally, but concerns remain about their quality and safety. New herbal products are constantly being introduced to the market under varying regulatory frameworks, with no global consensus on their definition or characterization. These biologically active mixtures are sold through complex globalized value chains, which create concerns around contamination and profit-driven adulteration. Industry, academia, and regulatory bodies must collaborate to develop innovative strategies for the identification and authentication of botanicals and their preparations to ensure quality control. High-throughput sequencing (HTS) has significantly improved our understanding of the total species diversity within DNA mixtures. The standard concept of DNA barcoding has evolved over the last two decades to encompass genomic data more broadly. Recent research in DNA metabarcoding has focused on developing methods for quantifying herbal product ingredients, yielding meaningful results in a regulatory framework. Techniques, such as loop-mediated isothermal amplification (LAMP), DNA barcode-based Recombinase Polymerase Amplification (BAR-RPA), DNA barcoding coupled with High-Resolution Melting (Bar-HRM), and microfluidics-based methods, offer more affordable tests for the detection of target species. While target capture sequencing and genome skimming are considerably increasing the species identification resolution in challenging plant clades, ddPCR enables the quantification of DNA in samples and could be used to detect intended and unwanted ingredients in herbal medicines. Here, we explore the latest advances in emerging DNA-based technologies and the opportunities they provide as taxa detection tools for evaluating the safety and quality of dietary supplements and herbal medicines.

Considered as the most complex joint of the human body, the temporomandibular joint is at the same time one of the main components of the stomatognathic system, contributing to its basic functions: mastication, swallowing, phonation. The study conducted includes a group of 38 patients, selected from on-call care between 2019-2021, aged 45-75), requiring restoration of functions affected by various forms of edentulousness), dental wear, and to treat complaints influencing the functionality of the temporomandibular joint. The determination of a complete clinical diagnosis was based on the information obtained from the history and thorough clinical examination The TMJ examination was performed according to the known clinical protocol, supplemented by the analysis of the TMJ profile CT scan, performed in the closed and open mouth position. compensatory possibilities of the tissues.The results of the tomographic analysis associated with the evaluation of clinical symptoms can be considered relevant and concordant for the functional importance of the TMJ, in addition to quantifying the sagittal condylar and glenoid dimensions and specifying the frequency of condylar position changes in a symptomatic or asymptomatic clinical context.

Sea buckthorn (Hippophae rhamnoides L.) (SB) is increasingly consumed worldwide as a food and food supplement. The remarkable richness in biologically active phytochemicals (polyphenols, carotenoids, sterols, vitamins) is responsible for its purported nutritional and health-promoting effects. Despite the considerable interest and high market demand for SB-based supplements, a limited number of studies report on the authentication of such commercially available products. Herein, untargeted metabolomics based on ultra-high-performance liquid chromatography coupled with quadrupole-time of flight mass spectrometry (UHPLC-QTOF-ESI+MS) were able to compare the phytochemical fingerprint of leaves, berries, and various categories of SB-berry herbal supplements (teas, capsules, tablets, liquids). By untargeted metabolomics, a multivariate discrimination analysis and a univariate approach (t-test and ANOVA) showed some putative authentication biomarkers for berries, e.g., xylitol, violaxanthin, tryptophan, quinic acid, quercetin-3-rutinoside. Significant dominant molecules were found for leaves: luteolin-5-glucoside, arginine, isorhamnetin 3-rutinoside, serotonin, and tocopherol. The univariate analysis showed discriminations between the different classes of food supplements using similar algorithms. Finally, eight molecules were selected and considered significant putative authentication biomarkers. Further studies will be focused on quantitative evaluation.

Type 1 diabetes mellitus is a chronic autoimmune disease that affects millions of people and generates high healthcare costs due to frequent complications when inappropriately managed. Our paper aimed to review the latest technologies used in T1DM management for better glycemic control and their impact on daily life for people with diabetes. Continuous glucose monitoring systems provide a better understanding of daily glycemic variations for children and adults and can be easily used. These systems diminish diabetes distress and improve diabetes control by decreasing hypoglycemia. Continuous subcutaneous insulin infusions have proven their benefits in selected patients. There is a tendency to use more complex systems, such as hybrid closed-loop systems that can modulate insulin infusion based on glycemic readings and artificial intelligence-based algorithms. It can help people manage the burdens associated with T1DM management, such as fear of hypoglycemia, exercising, and long-term complications. The future is promising and aims to develop more complex ways of automated control of glycemic levels to diminish the distress of individuals living with diabetes.

The aim of this work was to assess the level of microbial contamination and resistance of bacteria isolated from a highthroughput heavy pig slaughterhouse (approx. 4600 pigs/day) towards antimicrobials considered as critical for human, veterinary or both chemotherapies. Samples, pre-operative and operative, were obtained in 4 different surveys. These comprised environmental sampling, i.e. air (ntotal = 192) and surfaces (ntotal = 32), in four different locations. Moreover, a total of 40 carcasses were sampled in two different moments of slaughtering following Reg. (CE) 2073/2005. Overall, 60 different colonies were randomly selected from VRBGA plates belonging to 20 species, 15 genera and 10 families being Enterobacteriaceae, Moraxellaceae and Pseudomonadaceae the most represented ones. Thirty-seven isolates presented resistance to at least one molecule and seventeen were classified as multi-drug resistant. Enterobacteriaceae, particularly E. coli, displayed high MIC values towards trimethoprim, ampicillin, tetracycline and sulphametoxazole with MICmax of 16, 32, 32 and 512 mg/L, respectively. Moreover, isolated Pseudomonas spp. showed high MIC values in critical antibiotics such as ampicillin and azithromycin with MICmax of 32 and 64 mg/L, respectively. Additionally, in vitro biofilm formation assays demonstrated that fifteen of these isolates can be classified as strong biofilm formers. Results demonstrated that a high diversity of bacteria containing antibiotic resistant and multiresistant species is present in the sampled abattoir. Considering these findings, it could be hypothesised that the processing environment could be a potential diffusion determinant of antibiotic resistant bacteria through the food chain and operators.

Peter C Taylor,1 Codrina Ancuta,2 Orsolya Nagy,3 María C de la Vega,4 Andrey Gordeev,5 Radka Janková,6 Umut Kalyoncu,7 Ivan Lagunes-Galindo,3 Jadranka Morović-Vergles,8 Mariana Peixoto GU e Silva de Souza,9 Bernadette Rojkovich,10 Prodromos Sidiropoulos,11 Atsushi Kawakami12 1Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; 2Department of Rheumatology, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania; 3AbbVie Inc, North Chicago, IL, USA; 4CEIM Investigaciones Medicas, Buenos Aires, Argentina; 5V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation; 6Department of Pediatric and Adult Rheumatology, Faculty Hospital Motol, Prague, Czech Republic; 7Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey; 8Department of Internal Medicine, Division of Clinical Immunology, Allergology and Rheumatology, Dubrava University Hospital, University of Zagreb School of Medicine, Zagreb, Croatia; 9Santa Casa de Belo Horizonte, Belo Horizonte, Brazil; 10Department of Rheumatology and Physiotherapy, Polyclinic of the Hospitaller Brothers of St. John of God, Semmelweis University, Budapest, Hungary; 11Faculty of Medicine, University of Crete, Heraklion, Greece; 12Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanCorrespondence: Peter C TaylorBotnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UKTel +44 1865 227323Email peter.taylor@kennedy.ox.ac.ukBackground: Patients’ needs and perspectives are important determinants of treatment success in rheumatoid arthritis (RA). Assessing patients’ perspectives can help identify unmet needs and enhance the understanding of treatment benefits.Objective: The SENSE study assessed the impact of inadequate response to disease-modifying antirheumatic drugs (DMARDs) on treatment satisfaction, disease outcomes, and patient perspectives related to RA disease management.Methods: SENSE was a noninterventional, cross-sectional study conducted in 18 countries across Europe, Asia, and South America. Adult patients with poorly controlled RA of moderate/high disease activity were eligible. Patient satisfaction was assessed by the Treatment Satisfaction Questionnaire for Medication (TSQM v1.4). Treatment adherence, healthcare resource utilization (HRU), quality of life (QoL), work ability, digital health literacy (DHL), patient preference information, and treatment strategy were also assessed.Results: A total of 1624 patients were included in the study: most were female (84.2%) and middle-aged, and mean disease duration was 10.5 years. Mean TSQM global satisfaction subscore was 60.9, with only 13.5% of patients reporting good treatment satisfaction (TSQM global ≥ 80). The strongest predictor of good treatment satisfaction was treatment with advanced therapies. Most patients (87.4%) reported good treatment adherence. In general, patients had impaired QoL and work ability, high HRU, and 67.4% had poor DHL. Leading treatment expectations were “general improvement of arthritis” and “less joint pain”. Most patients preferred oral RA medications (60.7%) and rapid (≤ 1 week) onset of action (71.1%). “Increased risk for malignancies” and “increased risk for cardiovascular disease” were the least acceptable side effects. Despite suboptimal control, advanced therapies were only used in a minority of patients, and DMARD switches were planned for only half of the patients.Conclusion: Suboptimal disease control negatively impacts treatment satisfaction, work ability, QoL, and HRU. Data collected on patient perspectives may inform shared decision-making and optimize treat-to-target strategies for improving patient outcomes in RA.Keywords: adherence, digital health literacy, patient preference, rheumatoid arthritis, treatment satisfaction

ABSTRACT Objective The aim of the study was to assess the long-term impact of laparoscopic sleeve gastrectomy (LSG) on lipid profile, uric acid level and metabolic syndrome. Materials and methods A prospective study was performed between 2009-2014, evaluating long-term percentage of excesso body mass index loss (%EBMIL), lipid profile, uric acid level and metabolic syndrome. Results Overall sixty subjects were followed-up. %EBMIL increased significantly, reaching a maximum (86,9 ± 6,3%) at 5 years post-LSG. Therapeutic success rate (%EBMIL ≥ 60%) was 80% at 5 years. The triglyceride level decreased significantly (148 ± 72.1 mg/dL baseline vs 130.7 ± 57.5 mg/dL at 1 month vs 110.7 ± 42.6 mg/dL at 3 months vs 92.5 ± 35.2 mg/dL at 1 year vs 84.2 ± 32.3 mg/dL at 5 years; p < 0.05 for all). HDL-cholesterol increased and uric acid decreased significantly in the first year postoperatively, remaining stable afterwards (46.9 ± 12.3 mg/dL baseline vs 47.4 ± 10 mg/dL at 1 month vs 49.8 ± 9.3 mg/dL at 3 months vs 55.4 ± 10.2 mg/dL at 1 year; p < 0.05 for all for HDL-cholesterol and 6.4 ± 2 mg/dL baseline vs 6 ± 1.7 mg/dL at 1 month vs 5.2 ± 1.3 mg/dL at 3 months vs 4.8 ± 1 mg/dL at 1 year; p < 0.05 for all for uric acid). The prevalence of metabolic syndrome decreased from 66.7% baseline to 8.3% at 5 years postoperatively (p < 0.01). Conclusions LSG was effective in terms of %EBMIL and metabolic traits improvement for Romanian patients.

The aim of the present study was to obtain, characterize, and evaluate the antioxidant potential of some extracts obtained from the bark of Betula alba var. pendula Roth., the root of Glycyrrhiza glabra L., and the green herb of the Avena sativa. The results revealed that the lowest IC50 value, determined by all three methods, was obtained for Betulae extractum (BE) (73.6 µg/mL—DPPH method, 11.2 µg/mL—ABTS method, and 58.7 µg/mL—FRAP method), followed by Liquiritiae extractum (LE) (805.6 µg/mL, 92.1 µg/mL, and 722 µg/mL) and Avenae extractum (1.13 mg/mL—DPPH method, 99.7 µg/mL—ABTS method, and 135.1 µg/mL—FRAP method). These results correlate with total polyphenols content (expressed in g tannic acid/100 g dry extract), with BE having more polyphenols than LE and AE (47.96 ± 9.7083 for BE, compared with 9.31 ± 0.9913 for LE and 40.55 ± 6.3715 for AE). The total flavonoid content (expressed as g rutoside/100 g dry extract) is similar for BE and LE (3.75 ± 0.3140 and 3.44 ± 0.3037) and smaller for AE (1.95 ± 0.0526). Therefore, Betulae extractum has the strongest antioxidant action, with an IC50 value very close to the standard used as a reference (ascorbic acid—16.5 μg/mL solution). The FT-ICR-MS analysis confirmed the presence of the major compounds in all three extracts. The antioxidant properties of the studied extracts were further supported by molecular docking experiments that revealed the potential of the analyzed phytochemicals to act as both noncovalent and covalent activators of the Nrf2 signaling pathway, with promising benefits in treating various skin disorders.

One of the earliest biotechnological processes is brewing, which uses conventional raw materials like barley malt and, to a lesser extent, wheat malt. Today, adjuncts are used in the brewing of 85–90% of the world’s beer, with significant regional differences. The results of this study’s brewing were compared to those of beer made only from malted barley. Malted and unmalted sorghum were suggested for use in this study’s brewing. In order to improve the technical mashing operation and raise output yield, commercial enzymes were introduced. The following physicochemical analyses of the finished beer were carried out in accordance with regulatory requirements: original extract (% m/m), apparent extract (% m/m), alcohol content (% v/v, % m/m), density (g/cm3), turbidity (EBC), pH, color (EBC), bitterness value (IBU), oxygen content (mg/L), carbon dioxide content (g/L). A nine-point hedonic scale was used to conduct the sensory evaluation of the beer samples. Sorghum was easily included into the technological process to create a finished product that, in many ways, resembled traditional beer, making sorghum appropriate for typical beer drinkers. The laboratory brewing formula that produced the highest-quality results of all the tested variants included 60% sorghum malt and 40% unmalted sorghum: original extract 11.26% m/m, apparent extract 4.59% m/m, alcohol content 4.12% v/v, turbidity 0.74 EBC, CO2 content 5.10 g/L. The resulting sorghum beer typically has low alcohol content, a complex, aromatic, slightly sour flavor, a mild bitter or astringent sensation, and less stable foam.

Spent grain is the solid fraction remaining after wort removal. It is nutritionally rich, composed of fibers—mainly hemicellulose, cellulose, and lignin—proteins, lipids, vitamins, and minerals, and must be managed properly. Spent grain is a by-product with high moisture, high protein and high fiber content and is susceptible to microbial contamination; thus, a suitable, cost-effective, and environmentally friendly valorization method of processing it is required. This by-product is used as a raw material in the production of many other food products—bakery products, pasta, cookies, muffins, wafers, snacks, yogurt or plant-based yogurt alternatives, Frankfurter sausages or fruit beverages—due to its nutritional values. The circular economy is built on waste reduction and the reuse of by-products, which find opportunities in the regeneration and recycling of waste materials and energy that become inputs in other processes and food products. Waste disposal in the food industry has become a major issue in recent years when attempting to maintain hygiene standards and avoid soil, air and water contamination. Fortifying food products with spent grain follows the precepts of the circular bio-economy and industrial symbiosis of strengthening sustainable development. The purpose of this review is to update information on the addition of spent grain to various foods and the influence of spent grain on these foods.

Chronic venous disease is one of the most common vascular diseases; the signs and symptoms are varied and are often neglected in the early stages. Vascular damage is based on proinflammatory, prothrombotic, prooxidant activity and increased expression of several matrix metalloproteinases (MMPs). The aim of this research is preparation and preliminary characterization of three vegetal extracts (Sophorae flos-SE, Ginkgo bilobae folium-GE and Calendulae flos-CE). The obtained dry extracts were subjected to phytochemical screening (FT-ICR-MS, UHPLC-HRMS/MS) and quantitative analysis (UHPLC-HRMS/MS, spectrophotometric methods). Antioxidant activity was evaluated using three methods: FRAP, DPPH and ABTS. More than 30 compounds were found in each extract. The amount of flavones follows the succession: SE > GE > CE; the amount of phenolcarboxylic acids follows: SE > CE > GE; and the amount of polyphenols follows: SE > GE > CE. Results for FRAP method varied as follows: SE > CE > GE; results for the DPPH method followed: SE > GE > CE; and results for ABTS followed: SE > GE > CE. Strong and very strong correlations (appreciated by Pearson coefficient) have been observed between antioxidant activity and the chemical content of extracts. Molecular docking studies revealed the potential of several identified phytochemicals to inhibit the activity of four MMP isoforms. In conclusion, these three extracts have potential in the treatment of chronic venous disease, based on their phytochemical composition.

Milk thistle (Silybum marianum (L.) Gaertn.) is among the top-selling botanicals used as a supportive treatment for liver diseases. Silymarin, a mixture of unique flavonolignan metabolites, is the main bioactive component of milk thistle. The biological activities of silymarin have been well described in the literature, and its use is considered safe and well-tolerated in appropriate doses. However, commercial preparations do not always contain the recommended concentrations of silymarin, failing to provide the expected therapeutic effect. While the poor quality of raw material may explain the low concentrations of silymarin, its deliberate removal is suspected to be an adulteration. Toxic contaminants and foreign matters were also detected in milk thistle preparations, raising serious health concerns. Standard methods for determination of silymarin components include thin-layer chromatography (TLC), high-performance thin-layer chromatography (HPTLC), and high-performance liquid chromatography (HPLC) with various detectors, but nuclear magnetic resonance (NMR) and ultra-high-performance liquid chromatography (UHPLC) have also been applied. This review surveys the extraction techniques of main milk thistle metabolites and the quality, efficacy, and safety of the derived food supplements. Advanced analytical authentication approaches are discussed with a focus on DNA barcoding and metabarcoding to complement orthogonal chemical characterization and fingerprinting of herbal products.

With the goal of introducing specialty beers with full flavor and effective processing, craft and functional beer have revived old assortments and established new assortments in countries throughout the world. These unique selections are produced utilizing various ingredient combinations or changes to the brewing process. Given the rise in celiac disease sufferers in recent years, research investigations on the use of buckwheat in brewing, particularly gluten-free beer, have intensified. In this study, malted and unmalted buckwheat were proposed for use in brewing, and the results were contrasted with those of beer made entirely of malted barley. Commercial enzymes were added to the technical mashing process in order to optimize it and increase output yield. It was simple to incorporate buckwheat in the technological process to produce a final product that, in many respects, resembled conventional beer, making buckwheat suitable for regular beer drinkers. In terms of original extract, apparent extract, alcohol content, and energy value, the beer obtained from 100% barley malt differs from the final beer, but only minor variations were found in color, pH, and bitterness value. Ethyl alcohol, a particularly significant distinguishing characteristic, was impacted by the use of buckwheat malt and unmalted buckwheat. The beer made from buckwheat was acceptable from a sensory perspective in terms of flavor, aroma, texture, bitterness, etc. The results demonstrate that the researched raw materials can be successfully used in the production of beer, both in malted and unmalted forms. For the latter option, it is recommended to use enzyme preparations to speed up the mashing and filtration of the wort.

The present study aims to demonstrate the influence of the polymer-carrier type and proportion on the quality performance of newly developed oral immediate-release tablets containing amiodarone solid dispersions obtained by hot-melt extrusion. Twelve solid dispersions including amiodarone and different polymers (PEG 1500, PEG 4000; PEG 8000, Soluplus®, and Kolliphor® 188) were developed and prepared by hot-melt extrusion using a horizontal extruder realized by the authors in their own laboratory. Only eleven of the dispersions presented suitable physical characteristics and they were used as active ingredients in eleven tablet formulations that contain the same amounts of the same excipients, varying only in solid dispersion type. The solid dispersions’ properties were established by optical microscopy with reflected light, volumetric controls and particle size evaluation. In order to prove that the complex powders have appropriate physical characteristics for the direct compression process, they were subjected to different analyses regarding their flowability and compressibility behavior. Additionally, the Fourier transform infrared spectroscopy and X-ray diffraction analysis were performed on the obtained solid dispersions. After confirming the proper physical attributes for all blends, they were processed into the form of tablets by direct compression technology. The manufactured tablets were evaluated for pharmacotechnical (dimensions–diameter and thickness, mass uniformity, hardness and friability) and in vitro biopharmaceutical (disintegration time and drug release) performances. Furthermore, the influence of the polymer matrix on their quality was determined. The high differences in flow and compression performances of the solid dispersions prove the relevant influence of the polymer type and their concentration-dependent plasticizing properties. The increase in flowability and compressibility characteristics of the solid dispersions could be noticed after combining them with direct compression excipients owning superior mechanical qualities. The influence of the polymer type is best detected in the disintegration test, where the obtained values are quite different between the studied formulations. The use of PEG 1500 alone or combined in various proportions with Soluplus® leads to rapid disintegration. In contrast, the mixture of PEG 4000 and Poloxamer 188 in equal proportions determined the increase in disintegration time to 120 s. The use of Poloxamer 188 alone and a 3:1 combination of PEG 4000 and Soluplus® also generates a prolonged disintegration time for the tablets.

Herbs and spices are some of the most vulnerable products in terms of fraud and adulteration in the food sector. Although standard analytical methods are accurate for quality control of specific lead or marker compounds, they cannot accurately assess the entire species composition of many marketed products. Complementary analytical approaches are thus often used for comprehensive screening of herbs and spices. In this study we evaluate DNA metabarcoding for the identification and authentication of 62 products, containing basil, oregano, and paprika collected from different retailers and importers in Norway. Our results show varying degrees of discrepancy between the constituent species and those listed on the product labels, despite high product authenticity. We suggest the false positives result from the sensitivity of DNA metabarcoding and filtering thresholds should be integrated into protocols to reduce false positives. Our results highlight how integrating DNA metabarcoding into the toolbox of analytical methods for quality control of fresh and/or processed plant-based food can improve product quality.

This study aimed at determining the quality parameters of the wafer formulated with the addition of grain spent (SG), resulting from the obtainment of whisky. In this sense, wafers were formulated from chickpea flour, spent grain, wild garlic paste, golden flaxseed, and hemp seeds. These food products were analyzed in terms of texture, density, and pH of the batter, but also of the final product for proximate analysis, baking loss, texture, water activity, color, antioxidant capacity, water holding capacity and oil holding capacity, microstructure, and sensorial analysis. The addition of spent grain in the wafer formulation led to products with a high acceptability, the texture of the batter underwent changes due to the addition of spent grain, all parameters increased, and only adhesiveness decreased. The density and pH of the samples with SG decreased. The fracturability of the products with SG decreased with the addition of SG compared to the control sample, and the color becomes darker, influenced by the specific color of the SG. With the addition of spent grain, it increases the fiber and protein content, the antioxidant capacity, but also the baking loss due to the fibers contained in it. The microstructure of samples with the addition of SG shows a heterogeneous distribution of pores on the cross section of the samples, with larger pores in the center of the wafer samples.

Phenolic compounds represent an essential bioactive metabolites group with numerous pharmaceutical applications. Our study aims to identify and quantify phenolic constituents of various liquid and dry extracts of Usnea barbata (L.) Weber ex F.H. Wigg (U. barbata) from Calimani Mountains, Romania, and investigate their bioactivities. The extracts in acetone, 96% ethanol, and water with the same dried lichen/solvent ratio (w/v) were obtained through two conventional techniques: maceration (mUBA, mUBE, and mUBW) and Soxhlet extraction (dUBA, dUBE, and dUBW). High-performance liquid chromatography with diode-array detection (HPLC-DAD) was performed for usnic acid (UA) and different polyphenols quantification. Then, the total phenolic content (TPC) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) free-radical scavenging activity (AA) were determined through spectrophotometric methods. Using the disc diffusion method (DDM), the antibacterial activity was evaluated against Gram-positive and Gram-negative bacteria known for their pathogenicity: Staphylococcus aureus (ATCC 25923), Streptococcus pneumoniae (ATCC 49619), Pseudomonas aeruginosa (ATCC 27853), and Klebsiella pneumoniae (ATCC 13883). All extracts contain phenolic compounds expressed as TPC values. Five lichen extracts display various UA contents; this significant metabolite was not detected in dUBW. Six polyphenols from the standards mixture were quantified only in ethanol and water extracts; mUBE has all individual polyphenols, while dUBE shows only two. Three polyphenols were detected in mUBW, but none was found in dUBW. All U. barbata extracts had antiradical activity; however, only ethanol and acetone extracts proved inhibitory activity against P. aeruginosa, S. pneumoniae, and S. aureus. In contrast, K. pneumoniae was strongly resistant (IZD = 0). Data analysis evidenced a high positive correlation between the phenolic constituents and bioactivities of each U. barbata extract. Associating these extracts’ properties with both conventional techniques used for their preparation revealed the extraction conditions’ significant influence on lichen extracts metabolites profiling, with a powerful impact on their pharmacological potential.

Inflammation is a major pathogenic pathway in pulmonary chronic obstructive disease (COPD). Interleukin-6 (IL-6) mediates the local and systemic immune response. The aim consisted in investigating the relationship between IL-6 serum levels and IL-6 -597A/G gene polymorphism (rs1800797) with COPD. Serum levels of IL-6 were determined using an enzyme-linked immune-sorbent assay, in 120 participants (60 COPD patients and 60 healthy subjects), from Transylvanian region. The IL-6 -597A/G gene polymorphism was investigated by high molecular weight genomic DNA extracted from the peripheral blood leukocytes, and subsequently analyzed by the Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) technique. Smoking history, the severity of the disease, expressed by the GOLD stages, and arterial blood partial pressure of oxygen (PaO 2 ) levels were also investigated. COPD patients had significantly elevated blood levels of IL-6 when compared to the control group ( p

This study aimed to evaluate the molecular characteristics of methicillin resistant Staphylococcus aureus (MRSA) isolated in the swine chain in Northern Italy. A sample of 50 fattening units located in Lombardy was selected. Five cutaneous samples at slaughtering and three environmental samples at farm were collected from each unit giving a total of 250 and 150 samples, respectively. A total of 25 MRSA isolates were isolated from 400 samples, in 17 different fattening units. At farm, 12 out of 250 samples were positive for MRSA (4,8 %), and 13 out of 150 samples at slaughter were identified as MRSA (8,7 %), giving an overall incidence among samples of 6,25 % (n = 25). Molecular characterization was carried out using multi-locus sequence typing (MLST) and spa-typing. Outcomes showed that most of the isolates belonged to ST398, carrying spa-types t899, t011, t18498, t1939, t1200, and t304. Nonetheless, three isolates were identified as ST97 (t1730 and t4795), and one as ST30, showing spa-type t318. Furthermore, a novel ST was identified, namely 5422, showing spa-type t1730. Heterogeneity in genotypes within the same farm was also found in different fattening units, with concern for the possibility of the exchange of genetic determinants among different lineages. Genetic diversity among MRSA isolates in pig fattening units has been observed, highlighting the possibility that some isolates could be able to infect different hosts, including human.

Rheumatoid arthritis (RA) is one of the main chronic inflammatory rheumatic disorders characterized by chronic destructive peripheral arthritis as well as a wide range of systemic features, resulting in irreversible damage, significant disability, functional impairment and altered quality of life. Clinical temporomandibular joint (TMJ) involvement is commonly reported in up to 80% of RA patients. Although conventional radiological examination remains an important tool for diagnosis and assessment of TMJ disease, newer modern techniques including TMJ ultrasound, CT and cone beam CT (CBCT) are largely available and able to depict earlier changes in the TMJ. This report presents the clinical case of an established RA, emphasizing the potential diagnostic algorithm and therapeutic options for TMJ arthritis

The main aims of this paper were (i) to identify the pathology that occurs in the dentist’s hand in relation to different professional risk factors, particularly the trapezio-metacarpal osteoarthritis – a painful and highly disabling entity related to subluxation or dislocation complications, and (ii) to highlight the role of kinetotherapy for the prevention as well as therapy of the dentist’s hand. We enrolled twenty experienced dentists selected according to several inclusion criteria: a daily program of minimum 6 working hours, more than 15 years of professional experience, performing all techniques and procedures commonly encountered in a dental office. Dentists included in our research were classified in two main groups: group A performing an individual kinetotherapy program and group B without the kinetic program. Individualized kinetic programs aiming to reduce pain, restore joint mobility, tone different muscle groups and improve coordination are successful in refining work-related hand pathology in dentists.

Blackberries are rich in antioxidants due to their high polyphenol and vitamin content, making them an excellent source of health protection. It is well known that good quality juices and fruit extracts can be obtained only from high quality fruits. The aim of this research is to characterize the antioxidant properties of garden blackberries fruits grown in Turia (Romania). Extracts were made from blackberry fruits with four different solvents, and the antioxidant capacity was studied by applying DPPH and FRAP assay. The total phenolic content (with Folin–Ciocâlteu reagent), total anthocyanin content (with the pH differential method), and total flavonoid content (with aluminum chloride colorimetric method) were also measured. The quercetin and gallic acid content were also determined by HPLC-DAD. As the best results were obtained with 90% v/v acidified acetonitrile, the Hansen parameters analysis was performed for the acetonitrile-water solvent mixture as a solvent and cyanidin-3-O-glucoside as a solute.

The aim of this study was to assess symptoms and signs of temporomandibular joint (TMJ) involvement in patients with rheumatoid arthritis and to offer a complex outlook of the TMJ evaluation in routine practice in rheumatic patients. We performed a prospective observational study in consecutive patients with different inflammatory and degenerative rheumatic conditions and secondary TMJ involvement, aiming to realise a complex (epidemiological, clinical, biological and imaging) description of TMJ pathology. The results of the present study showed that TMJ involvement was usually reported in different RA subtypes. The presence of TMJ issues was significantly associated with several individual RA parameters defining disease activity such as tender and swollen joints and also with disability and impaired life quality as suggested by high HAQ scores. TMJ pathology remains a major cause of altered quality of life in patients with chronic inflammatory rheumatic conditions such as RA.