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The huge amount of citrus peel produced worldwide represents an economic burden for society. However, this agricultural by-product is a rich source of natural molecules, potentially endowed with interesting pharmacological activities. In this regard, we decided to investigate if the polymethoxyflavones contained in citrus peel waste could be exploited as novel vasorelaxant agents. A hydroalcoholic blond orange (Citrus sinensis) peel extract, obtained by ultrasonication, was partitioned in dichloromethane. Column chromatography allowed for the isolation of four polymethoxyflavones, namely, scutellarein tetramethyl ether, nobiletin, tangeretin, and sinensetin, identified by nuclear magnetic resonance (NMR) spectroscopy and UPLC-HRMS/MS and confirmed by multivariate curve resolution of NMR fractional spectra. The four molecules showed interesting in vitro vasorelaxant activity, at least, in part, due to the blockade of smooth muscle CaV1.2 channels. Molecular modeling and docking analysis elucidated the binding mode of the polymethoxyflavones at the homology model of the rat CaV1.2c subunit and provided the structural basis to rationalise the highest activity of scutellarein tetramethyl ether in the set and the dramatic effect of the additional methoxy group occurring in nobiletin and sinensetin. In conclusion, citrus peel can be considered a freely available, valuable source of vasoactive compounds worthy of pharmaceutical and/or nutraceutical exploitation.

Carob pulp flour has antidiabetic and antioxidant activities, is naturally sweet, and is rich in fibers. It is obtained from carob pod pulp from the evergreen tree Ceratonia siliqua L., which is grown in Mediterranean areas and is known for locust bean gum production. Despite its valuable effects on health, such as the modulation of the glycemic index, this ingredient has a tremendous impact on technological and hedonic features, mainly on color, flavor, and texture. In this paper, the qualitative features and consumers’ acceptance of a carob-based gluten-free bakery product where rice flour was substituted at 40% with carob pulp flour were studied. A panel group of experts described the bread as dark, quite dense, sweet, aromatic, and with a limited bubble dispersion. On the other hand, the sensory assessment and the willingness to pay of consumers were assessed in two groups (a fully informed one about heathy attributes of the food and a blind one). The results indicated a moderate appreciation of the overall quality of the product (average score between 4 and 5 points on a 9-point Likert scale). The information about the food’s healthy properties and the ability to maintain a low glycemic index did not enhance the consumers’ perception of the product, while previous knowledge and involvement in the product consumption were perceived to have primary importance regarding the final consumers’ choice. Finally, an accelerated shelf-life test was run on the packaged snack to evaluate the general quality and stability. The protective packaging helped in limiting bread decay and maintaining the textural characteristics.

In recent years, there has been a concerning surge in waste generation, with agri-food waste emerging as a significant issue across various stages of the food supply chain [...]

A quercetin derivative with remarkable biological performance was successfully synthesized by chemical modification of the flavonoid with docosahexaenoic acid to synthesize 2-(2,2-diphenylbenzo[d][1,3]dioxol-5-yl)-5,7-dihydroxy-4-oxo-4H-chromen-3-yl-(4Z,7Z,10Z,13Z,16Z,19Z)-docosa-4,7,10,13,16,19-hexaenoate (3), deeply characterized by NMR spetroscopy. Modified quercetin and pectin were involved in a grafting process by an ecofriendly radical procedure able to preserve the biological features of the quercetin derivative. Antioxidant performances of the conjugate were evaluated both in term of total phenolic amount and scavenger activity in organic and aqueous environments. Additionally, in vitro acute oral toxicity was also tested against Caco-2 cells and 3T3 fibroblasts, confirming that pectin conjugate does not have any effect on cell viability at the dietary use concentrations. Finally, in vitro experiments highlighted the ability of the conjugate to counteract the migratory properties of Caco-2 and HepG2 cells, indicating its feature in the reduction of the migration of tumour cells. These data showed that the covalent binding of the quercetin derivative to the pectin chain represents a very interesting strategy to improve the bioavailability of the quercetin, representing an effective means of protecting and to transporting polyphenol molecules.

Abstract Asexual, lesbian, gay, bisexual, and trans (ALGBT) individuals face worse life conditions and violence rates than their heterosexual cisgender counterparts. Brazil is often highlighted for having one of the highest rates of hate-related homicides against ALGBTs in the world. However, to date, Brazil’s ALGBT population has not been investigated with a representative sample, and basic information such as population size or sociodemographic characteristics are mostly based in non-systematic data. We aimed to assess the proportion of asexual, lesbian, gay, bisexual, trans and non-binary adults in Brazil, their sociodemographic characteristics, and self-reported violence rates. In 2018, a sample (n = 6000) of the Brazilian adult population answered a face-to-face survey assessing sociodemographic characteristics, gender identity, sexual orientation, and self-reported psychological, physical, verbal, and sexual violence. Among Brazilian adults, 12.04% are ALGBT: 5.76% asexual, 0.93% lesbian, 1.37% gay, 2.12% bisexual, 0.68 trans, and 1.18% non-binary. Compared to heterosexual cisgender men, most ALGBT individuals have worse socioeconomic indicators and higher rates of self-reported psychological and verbal violence. All ALGBT groups and heterosexual cisgender women reported sexual violence more often than heterosexual cisgender men. It was reported between 4 up to 25 times more often by heterosexual cisgender women and trans individuals, respectively. The rates of the other ALGBT groups sit among the two. Our findings provide evidence of the important size of the ALGBT Brazilian population, as well as their socioeconomic vulnerability, and concerning violence levels experienced by the group. Policy makers may refer to the present article in order to mitigate this population’s vulnerability and to better understand its sociodemographic characteristics.

The huge amount of citrus peel produced worldwide represents an economic burden for society. However, this agricultural by-product is a rich source of natural molecules, potentially endowed with interesting pharmacological activities. In this regard, we decided to investigate if the polymethoxyflavones contained in citrus peel waste could be exploited as novel vasorelaxant agents. A hydroalcoholic blond orange (Citrus sinensis) peel extract, obtained by ultrasonication, was partitioned in dichloromethane. Column chromatography allowed for the isolation of four polymethoxyflavones, namely, scutellarein tetramethyl ether, nobiletin, tangeretin, and sinensetin, identified by nuclear magnetic resonance (NMR) spectroscopy and UPLC-HRMS/MS and confirmed by multivariate curve resolution of NMR fractional spectra. The four molecules showed interesting in vitro vasorelaxant activity, at least, in part, due to the blockade of smooth muscle CaV1.2 channels. Molecular modeling and docking analysis elucidated the binding mode of the polymethoxyflavones at the homology model of the rat CaV1.2c subunit and provided the structural basis to rationalise the highest activity of scutellarein tetramethyl ether in the set and the dramatic effect of the additional methoxy group occurring in nobiletin and sinensetin. In conclusion, citrus peel can be considered a freely available, valuable source of vasoactive compounds worthy of pharmaceutical and/or nutraceutical exploitation. [ABSTRACT FROM AUTHOR]

In this work, the peels of red and blonde oranges as well as lemons were efficiently (5.75–9.65% yield) extracted by hydroalcoholic solution with ultrasound assistance and employed as active molecule sources in the preparation of functional gummies. Antioxidant performances of the hydroalcoholic extracts were characterized by colorimetric assays, whereas LC–HRMS analyses identified the main bioactive compounds (phenolic acids and flavonoids). The highest scavenging activity was recorded for lemon extract in an aqueous environment (IC50 = 0.081 mg mL−1). An ecofriendly grafting procedure was performed to anchor polyphenols to gelatin chains, providing macromolecular systems characterized by thermal analysis and antioxidant properties. Scavenger abilities (IC50 = 0.201–0.454 mg mL−1) allowed the employment of the conjugates as functional ingredients in the preparation of gummies with remarkable antioxidant and rheological properties over time (14 days). These findings confirmed the possible employment of highly polluting wastes as valuable sources of bioactive compounds for functional gummies preparation.

Background We aimed to determine the prevalence of hypoalbuminemia in STEC-HUS patients with hemorrhagic colitis (HC) and whether serum albumin level (SAL), leukocyte count, hematocrit and serum sodium level (SSL) are prognostic markers of HC, central nervous system disease (CNSd) and/or dialysis requirement and evaluate if hypoalbuminemia is associated with fecal protein losses. Methods We prospectively evaluated STEC-HUS patients treated at our institution from 9/2011 to 2/2019, analyzing the presence of HC, CNSd and dialysis requirement and SAL, SSL, leukocytes, hematocrit and [alpha]1-antitrypsin clearance. Results We evaluated 98 patients, with mean age of 33.3 months. SAL [less than or equal to] 29.5 g/l, > 24,600 leukocytes/mm.sup.3 and hematocrit > 30% behave as independent prognostic markers for HC. SAL [less than or equal to] 28 g/l, > 25,200 leukocytes/mm.sup.3 and hematocrit > 30% behave as prognostic markers for CNSd. SAL [less than or equal to] 31.6 g/l, > 13,800 leukocytes/mm.sup.3, hematocrit > 18.9% and hyponatremia ([less than or equal to] 132 mEq/l) behave as prognostic markers for dialysis requirement. However, in multivariate logistic regression models, only hypoalbuminemia behaved as a risk factor for HC, CNSd and dialysis. [alpha]1-antitrypsin clearance was performed in 69 patients and was high in 9/69 (13%), only 4 with HC. No significant association was observed between [alpha]1-antitrypsin clearance and albuminemia ([chi].sup.2 = 0.1076, p = 0.7429) as well as [alpha]1-antitrypsin clearance and HC ([chi].sup.2 = 1.7892, p = 0.1810). Conclusions Almost all patients with HC had hypoalbuminemia, which behaves as a risk factor for HC, CNSd and dialysis requirement. No significant association was observed between elevated [alpha]1-antitrypsin clearance and hypoalbuminemia nor between elevated [alpha]1-antitrypsin clearance and HC. These findings could be related to the small number of evaluated patients., Author(s): Carlos J. Cobeñas [sup.1] , Laura L. Lombardi [sup.1] , Priscila Pereyra [sup.1] , Emanuel De Rose [sup.1] , María José Gogorza [sup.1] , Ana Paula Spizzirri [sup.1] , [...]

Abstract Background Acute appendicitis is one of the most frequent abdominal surgical emergencies. Intra-abdominal abscess is a frequent post-operative complication. The aim of this meta-analysis was to compare peritoneal irrigation and suction versus suction only when performing appendectomy for complicated appendicitis. Methods According to PRISMA guidelines, a systematic review was conducted and registered into the Prospero register (CRD42020186848). The risk of bias was defined to be from low to moderate. Results Seventeen studies (9 RCTs and 8 CCTs) were selected, including 5315 patients. There was no statistical significance in post-operative intra-abdominal abscess in open (RR 1.27, 95% CI 0.75–2.15; I 2 = 74%) and laparoscopic group (RR 1.51, 95% CI 0.73–3.13; I 2 = 83%). No statistical significance in reoperation rate in open (RR 1.27, 95% CI 0.04–2.49; I 2 = 18%) and laparoscopic group (RR 1.42, 95% CI 0.64–2.49; I 2 = 18%). In both open and laparoscopic groups, operative time was lower in the suction group (RR 7.13, 95% CI 3.14–11.12); no statistical significance was found for hospital stay (MD − 0.39, 95% CI − 1.07 to 0.30; I 2 = 91%) and the rate of wound infection (MD 1.16, 95% CI 0.56–2.38; I 2 = 71%). Conclusions This systematic review has failed to demonstrate the statistical superiority of employing intra-operative peritoneal irrigation and suction over suction-only to reduce the rate of post-operative complications after appendectomy, but all the articles report clinical superiority in terms of post-operative abscess, wound infection and operative times in suction-only group.

A baked gluten-free pastry was formulated using milk kefir, rice, and different amounts of carob pulp flour, i.e., 20% (B1) and 40% (B2). In all cases, B2 showed the most remarkable antioxidant properties in terms of total phenolic, phenolic acid, and flavonoid content, as well as scavenging activity both in aqueous and organic media. This trend was observed over a 6-day storage time. Lower cohesive interactions among dough aggregate domains were recorded as the carob pulp flour amount increased. At the same time, rigidity decreased in the order B0 > B1 > B2 as confirmed by lower textural properties shown by the carob-added samples. Sensory analysis recorded overall acceptability for both B1 and B2, with sweetness, cocoa, gingerbread, and rye aroma as predominant descriptors. The glycemic index determination confirmed a better score for B2 and revealed a medium GI value (62), in comparison with high GIs recorded for B1 and B0 (115 and 100, respectively).

Carob pulp flour has antidiabetic and antioxidant activities, is naturally sweet, and is rich in fibers. It is obtained from carob pod pulp from the evergreen tree Ceratonia siliqua L., which is grown in Mediterranean areas and is known for locust bean gum production. Despite its valuable effects on health, such as the modulation of the glycemic index, this ingredient has a tremendous impact on technological and hedonic features, mainly on color, flavor, and texture. In this paper, the qualitative features and consumers' acceptance of a carob-based gluten-free bakery product where rice flour was substituted at 40% with carob pulp flour were studied. A panel group of experts described the bread as dark, quite dense, sweet, aromatic, and with a limited bubble dispersion. On the other hand, the sensory assessment and the willingness to pay of consumers were assessed in two groups (a fully informed one about heathy attributes of the food and a blind one). The results indicated a moderate appreciation of the overall quality of the product (average score between 4 and 5 points on a 9-point Likert scale). The information about the food's healthy properties and the ability to maintain a low glycemic index did not enhance the consumers' perception of the product, while previous knowledge and involvement in the product consumption were perceived to have primary importance regarding the final consumers' choice. Finally, an accelerated shelf-life test was run on the packaged snack to evaluate the general quality and stability. The protective packaging helped in limiting bread decay and maintaining the textural characteristics. [ABSTRACT FROM AUTHOR]

Abstract Studies estimate that gender-diverse persons represent 0.1 to 2% of populations investigated, but no such assessment was performed in Latin America. In a representative sample of Brazil’s adult population (n = 6000), we investigated participants' sociodemographic characteristics and possible associations between these and current gender identity, categorized as cisgender, transgender or non-binary gender. We also investigated transgender individuals' distress associated with gender-related body characteristics. As main results, we found that transgender individuals represented 0.69% (CI95% = 0.48–0.90) of the sample, whereas non-binary persons were 1.19% (CI95% = 0.92–1.47). These percentages were not different among Brazil’s 5 geographic regions. Preliminary analyses showed that transgender individuals were on average younger (32.8 ± 14.2 years, CI95% = 28.5–37.1), compared to cisgender (42.2 ± 15.9, CI95% = 42.5–42.8) and non-binary (42.1 ± 16.5 years, CI95% = 38.3–46.5) groups. Non-binary persons are less likely to be in a relationship compared to cisgender individuals (OR = 0.57, CI95% = 0.35–0.93). In the transgender group, 85% of transgender men and 50% of transgender women reported distress due to gender-related body characteristics. Our main findings draw attention that gender-diverse Brazilian individuals represent around 2% of the country's adult population (almost 3 million people), and are homogeneously located throughout the country, reiterating the urgency of public health policies for these individuals in the five Brazilian sub-regions.

This paper presents a methodology tuned to support the management of underground pipelines (sewer and aqueduct networks) in Rome, often threatened by the sudden formation of sinkholes related to the upward migration of existing underground cavities. The methodology integrates data coming from the assessment of susceptibility to sinkhole formation and the advanced processing of satellite-based SAR imagery. The former, performed through the multivariate logistic regression technique, relies on a detailed database of stratigraphic and other thematic (i.e. sinkhole inventory and density of underground cavities) information. A-DInSAR processing of satellite images, for which we developed on-purpose algorithms to filter only data relevant for the process under study, allowed us to provide density maps of subsiding reflectors whose likelihood to be precursors of sinkhole collapses is rated based on the integration with the susceptibility map. The procedure is addressed to point out potentially critical ‘hotspots’ that the company managing the underground networks should pay attention to by means of further detailed investigations. Recent (i.e. occurred after the finalization of the products shown in this paper) sinkholes validated the reliability of the procedure adopted, whose strength is the data fusion able to produce refined and focused information starting from independent and more generic datasets.

Abstract Introduction The incidence of synchronous RCC and colorectal cancer is heterogeneous ranging from 0.03 to 4.85%. Instead, only one case of huge colon carcinoma and renal angiomyolipoma was reported. The treatment of synchronous kidney and colorectal neoplasm is, preferably, synchronous resection. Currently, laparoscopic approach has shown to be feasible and safe, and it has become the gold standard of synchronous resection due to advantages of minimally invasive surgery. We presented a case synchronous renal neoplasm and colorectal cancer undergone simultaneous totally robotic renal enucleation and rectal resection with primary intracorporeal anastomosis. As our knowledge, this is the first case in literature of simultaneous robotic surgery for renal and colorectal tumor. Case presentation A 53-year-old woman was affected by recto-sigmoid junction cancer and a solid 5 cm left renal mass. We performed a simultaneous robotic low anterior rectal resection and renal enucleation. Total operative time was 260 min with robotic time of 220 min; estimated blood loss was 150 ml; time to flatus was 72 h, and oral diet was administered 4 days after surgery. The patient was discharged on the eighth post-operative day without peri- and post-operative complication. The definitive histological examination showed a neuroendocrine tumor pT2N1 G2, with negative circumferential and distal resection margins. Renal tumor was angiomyolipoma. At 23 months follow-up, the patient is recurrence free. Discussion and conclusion As our knowledge, we described the first case in literature of simultaneous robotic anterior rectal resection and partial nephrectomy for treatment of colorectal tumor and renal mass. Robotic rectal resection with intracorporeal anastomosis surgery seems to be feasible and safe even when it is associated with simultaneous partial nephrectomy. Many features of robotic technology could be useful in combined surgery. This strategy is recommended only when patients’ medical conditions allow for longer anesthesia exposure. The advantages are to avoid a delay treatment of second tumor, to reduce the time to start the post-operative adjuvant chemotherapy, to avoid a second anesthetic procedure, and to reduce the patient discomfort. However, further studies are needed to evaluate robotic approach as standard surgical strategy for simultaneous treatment of colorectal and renal neoplasm.

An ultrasound-assisted extraction method, employing ethanol and water as solvents at low temperature (30 °C) and reduced time (15 min), was proposed to extract bioactive molecules from different cultivars (Magliocco Canino, Magliocco Rosato, Gaglioppo, and Nocera Rosso) of wine lees. All the extract yields were evaluated and their contents of phenolic acids, flavonoids, and total polyphenols were determined by means of colorimetric assays and high-performance liquid chromatography coupled with diode-array detection (HPLC-DAD) and Fourier transform infrared (FTIR) techniques. Radical scavenging assays were performed and the Magliocco Canino extracted with a hydroalcoholic mixture returned the best results both against ABTS (0.451 mg mL−1) and DPPH (0.395 mg mL−1) radicals. The chemometric algorithms principal component analysis (PCA) and partial least square regression (PLS) were used to process the data obtained from all qualitative–quantitative sample determinations with the aim of highlighting data patterns and finding possible correlations between composition and antioxidant features of the different wine lees cultivars and the extraction procedures. Wine lees from Magliocco Canino and Magliocco Rosato were found to be the best vegetable matrices in terms of metabolite content and antioxidant properties. The components extracted with alcoholic or hydroalcoholic solvents, specifically (−)-epigallocatechin gallate, chlorogenic acid, and trans-caftaric acid, were found to be correlated with the antioxidant capacity of the extracts. Multivariate data processing was able to identify the compounds related to the antioxidant features. Two PLS models were optimized by using their concentration levels to predict the IC50 values of the extracts in terms of DPPH and ABTS with high values of correlation coefficient R2, 0.932 and 0.824, respectively, and a prediction error lower than 0.07. Finally, cellular (SH-SY5Y cells) antioxidant assays were performed on the best extract (the hydroalcoholic extract of Magliocco Canino cv) to confirm its biological performance against radical species. All these recorded data strongly outline the aptness of valorizing wine lees as a valuable source of antioxidants.

Rapid and complete wound healing is a clinical emergency, mainly in pathological conditions such as Type 2 Diabetes mellitus. Many therapeutic tools are not resolutive, and the research for a more efficient remedial remains a challenge. Wound dressings play an essential role in diabetic wound healing. In particular, biocompatible hydrogels represent the most attractive wound dressings due to their ability to retain moisture as well as ability to act as a barrier against bacteria. In the last years, different functionalized hydrogels have been proposed as wound dressing materials, showing encouraging outcomes with great benefits in the healing of the diabetic wounds. Specifically, because of their excellent biocompatibility and biodegradability, natural bioactive compounds, as well as biomacromolecules such as polysaccharides and protein, are usually employed in the biomedical field. In this review, readers can find the main discoveries regarding the employment of naturally occurring compounds and biopolymers as wound healing promoters with antibacterial activity. The emerging approaches and engineered devices for effective wound care in diabetic patients are reported and deeply investigated.