Clinical Validation of Digital Healthcare Solutions: State of the Art, Challenges and Opportunities.

Digital health technologies (DHTs) at the intersection of health, medical informatics, and business aim to enhance patient care through personalised digital approaches. Ensuring the efficacy and reliability of these innovations demands rigorous clinical validation. A PubMed literature review (January 2006 to July 2023) identified 1250 papers, highlighting growing academic interest. A focused narrative review (January 2018 to July 2023) delved into challenges, highlighting issues such as diverse regulatory landscapes, adoption issues in complex healthcare systems, and a plethora of evaluation frameworks lacking pragmatic guidance. Existing frameworks often omit crucial criteria, neglect empirical evidence, and clinical effectiveness is rarely included as a criterion for DHT quality. The paper underscores the urgency of addressing challenges in accreditation, adoption, business models, and integration to safeguard the quality, efficacy, and safety of DHTs. A pivotal illustration of collaborative efforts to address these challenges is exemplified by the Digital Health Validation Center, dedicated to generating clinical evidence of innovative healthcare technologies and facilitating seamless technology transfer. In conclusion, it is necessary to harmonise evaluation approaches and frameworks, improve regulatory clarity, and commit to collaboration to integrate rigorous clinical validation and empirical evidence throughout the DHT life cycle.

Carcass Yields and Meat Composition of Roosters of the Portuguese Autochthonous Poultry Breeds: "Branca", "Amarela", "Pedrês Portuguesa", and "Preta Lusitânica".

Poultry meat is an important part of the human diet, and the valorisation of autochthonous breeds is a determinant for the sustainability of the rural areas. The increasing demand for niche products demands for better knowledge of the carcass characteristics and meat quality of these local populations. The present study aims to characterise the roosters' meat from the "Branca" (BR), "Amarela" (AM), "Pedrês Portuguesa" (PP), and "Preta Lusitânica" (PL) breeds. A total of 80 birds (n = 20 per breed) between 38 and 42 weeks old were slaughtered. The physicochemical and nutritional composition were determined in the breast and drumstick meat. The meat of the PL breed had a higher (p ≤ 0.05) pH value, the AM meat revealed a water-holding capacity (WHC) of superior value and moisture content (p ≤ 0.05), while the BR breed had the highest (p ≤ 0.05) ash content. On the other hand, it was observed that the PP meat had a higher (p ≤ 0.05) yellowness index (b*). The breast meat exhibited, in all breeds, a lower pH value, WHC, redness (a*), and lipid content and greater (p ≤ 0.05) lightness (L*), b*, moisture, and ash and protein contents compared to the drumstick. Furthermore, it presented higher (p ≤ 0.05) K, P, and Mg contents and a superior proportion of total and sensorial relevant amino acids. Regarding the fatty acid profile, the breed differences were more significant in the drumstick, with the AM breed lipids presenting a higher (p ≤ 0.05) percentage of MUFAs in the fat, a lower atherogenic index, and a higher (p ≤ 0.05) value for the hypocholesterolemic/hypercholesterolemic fatty acids ratio, while the BR breed lipids presented a higher (p ≤ 0.05) percentage of PUFAs and PUFAs/SFAs ratio and a lower n-6/n-3 ratio. Considering the results obtained, it can be concluded that the meat from these breeds is a wholesome dietary option, distinguished by a favourable overall nutritional composition marked by elevated protein content, reduced lipid amounts, and amino and fatty acid profiles with desirable nutritional indices.

Non disseminative nano-strategy against in vivo Staphylococcus aureus biofilms.

Staphylococcus aureus is considered a high priority pathogen by the World Health Organization due to its high prevalence and the potential to form biofilms. Currently, the available treatments for S. aureus biofilm-associated infections do not target the extracellular polymeric substances (EPS) matrix. This matrix is a physical barrier to bactericidal agents, contributing to the increase of antimicrobial tolerance. The present work proposes the development of lipid nanoparticles encapsulating caspofungin (CAS) as a matrix-disruptive nanosystem. The nanoparticles were functionalized with D-amino acids to target the matrix. In a multi-target nano-strategy against S. aureus biofilms, CAS-loaded nanoparticles were combined with a moxifloxacin-loaded nanosystem, as an adjuvant to promote the EPS matrix disruption. In vitro and in vivo studies showed biofilm reduction after combining the two nanosystems. Besides, the combinatory therapy showed no signs of bacterial dissemination into vital organs of mice, while dissemination was observed for the treatment with the free compounds. Additionally, the in vivo biodistribution of the two nanosystems revealed their potential to reach and accumulate in the biofilm region, after intraperitoneal administration. Thus, this nano-strategy based on the encapsulation of matrix-disruptive and antibacterial agents is a promising approach to fight S. aureus biofilms.

Combined effects of climate change and BDE-209 dietary exposure on the behavioural response of the white seabream, Diplodus sargus.

Decabromodiphenyl-ether (BDE-209) is a persistent organic pollutant ubiquitously found in marine environments worldwide. Even though this emerging chemical contaminant is described as highly toxic, bioaccumulative and biomagnifiable, limited studies have addressed the ecotoxicological implications associated with its exposure in non-target marine organisms, particularly from a behavioural standpoint. Alongside, seawater acidification and warming have been intensifying their impacts on marine ecosystems over the years, compromising species welfare and survival. BDE-209 exposure as well as seawater acidification and warming are known to affect fish behaviour, but information regarding their interactive effects is not available. In this study, long-term effects of BDE-209 contamination, seawater acidification and warming were studied on different behavioural traits of Diplodus sargus juveniles. Our results showed that D. sargus exhibited a marked sensitivity in all the behaviour responses after dietary exposure to BDE-209. Fish exposed to BDE-209 alone revealed lower awareness of a risky situation, increased activity, less time spent within the shoal, and reversed lateralization when compared to fish from the Control treatment. However, when acidification and/or warming were added to the equation, behavioural patterns were overall altered. Fish exposed to acidification alone exhibited increased anxiety, being less active, spending more time within the shoal, while presenting a reversed lateralization. Finally, fish exposed to warming alone were more anxious and spent more time within the shoal compared to those of the Control treatment. These novel findings not only confirm the neurotoxicological attributes of brominated flame retardants (like BDE-209), but also highlight the relevance of accounting for the effects of abiotic variables (e.g. pH and seawater temperature) when investigating the impacts of environmental contaminants on marine life.

Does an eHealth Intervention Reduce Complications and Healthcare Resources? A mHeart Single-Center Randomized-Controlled Trial.

(1) Background: In the mHeart trial, we showed that an eHealth intervention, mHeart, improved heart transplant (HTx) recipients' adherence to immunosuppressive therapy compared with the standard of care. Herein, we present the analysis assessing whether mHeart reduces complication frequency and healthcare resource use, and whether this reduction depends on patients' adherence. (2) Methods: The mHeart was a single-center randomized-controlled trial (IIBSP-MHE-2014-55) in 134 adult HTx recipients (n = 71 intervention; n = 63 controls). The endpoints were mortality, complications, and resource use during follow-up (mean 1.6 ± 0.6 years). (3) Results: A significantly lower proportion of HTx recipients in mHeart had echocardiographic alteration (2.8% vs. 13.8%; p = 0.02), cardiovascular events (0.35% vs. 2.4%; p = 0.006), infections (17.2% vs. 56%; p = 0.03), and uncontrolled Hba1c (40.8% vs. 59.6%; p = 0.03) than controls. In addition, a significantly lower proportion of patients in the intervention needed hospital (32.4% vs. 56.9%; p = 0.004) or urgent admissions (16.9% vs. 41.4%; p = 0.002) and emergency room visits (50.7% vs. 69.0%; p = 0.03). Adherence status (measured by the self-reported SMAQ) influenced only controls regarding hospitalizations and emergency room visits. Differences were not significant on deaths (intervention 4.2% vs. control 9.5%; p = 0.4) (4) Conclusions: the mHeart strategy significantly reduced the occurrence of the studied post-transplant complications and the need for medical attention in HTx recipients. Adherence status influenced controls in their need for medical care.

Retinoic acid (all-trans) presents antioxidant properties within human ovary and reduces progesterone production by human granulosa cells.

Both vitamin A and E support female reproduction and embryonic development. These vitamins have been associated with decreased fertility or failure to end the pregnancy in animals. An observational study was conducted on follicular fluid (FF) samples to determine the concentrations of fat-soluble vitamins of women undergoing in vitro fertilization and its correlation with assisted reproductive technology characteristics and pregnancy outcomes. Moreover, the effects of all-trans-retinoic acid (atRA) and alpha-tocopherol on granulosa cell viability, apoptosis, autophagy and hormonal production were evaluated. No association was identified between fat-soluble vitamin concentrations in FF and infertility aetiology, body mass index or woman's age. There were differences in follicular antioxidant profiles and ovarian response stimulation. In vitro evaluation of atRA and alpha-tocopherol reveals that, at physiological concentrations, both compounds may affect the viability of granulosa cells. In addition, these compounds are able to protect granulosa cells from oxidative stress, as well as to affect estradiol and progesterone production. Our data suggest that atRA and alpha-tocopherol levels should be well controlled as they may have implications in the function and viability of granulosa cells and highlights retinol as a marker of the oxidative defenses within ovary environment.

Olive and echium oil gelled emulsions: Simulated effect of processing temperature, gelling agent and in vitro gastrointestinal digestion on oxidation and bioactive compounds.

The impact and relative relevance of in vitro gastrointestinal digestion, processing temperature (room temperature or 180 °C), and gelling agent (GA) (carrageenan and alginate) on the bioactive compounds and oxidation status of olive and echium oils gelled formulations with 40% lipid incorporation was assessed. In vitro digestion was not affected by the GA, with >90% lipolysis in all formulations, but was the most relevant variable, promoting oxidation (MDA) regardless of the oil type, GA or temperature applied. Tocopherols and phenolic decreased with digestion, which could be interpreted as a protective response to pro-oxidative conditions during digestion. Temperature decreased olive oil phenolics. Gelification of echium oil using alginate reduced secondary oxidation products formation in comparison with carrageenan, with oxidation degrees after digestion equivalent to those shown with olive oil. The use of alginate with olive oil resulted in the most stable formulations, although not protecting its minor bioactive compounds from thermal degradation.

[Reregistration of the population residing in Foz do Iguaçu, Brazil, in compliance with the Primary Health Care PolicyReinscripción de la población residente en Foz do Iguaçu, Brasil, en cumplimiento de la Política de atención primaria de salud]. / Recadastramento da população residente em Foz do Iguaçu, Brasil, em atendimento à Política de Atenção Primária à Saúde.

Objective: To present the experience and results of the reregistration of residents in Foz do Iguaçu, a border town located in the state of Paraná, Brazil, to meet the guidelines of the national Primary Health Care (PHC) Policy and its new financing model (Programa Previne Brasil). Method: A scanning strategy (convenience sample) was used for data collection, with 52 263 households visited and 22 710 interviews conducted from September to November 2019. The interviews were conducted face-to-face by 54 community health workers. Data were collected on the household (ownership status, urban or rural location, type of household, construction material, availability of electrical and sewage networks, water supply and waste disposal). Demographic and health information on the residents was also collected. Results: The reregistration process revealed that most residents were home owners and lived in well-constructed homes, located mostly in urban areas, served by electricity, with access to water supply and garbage collection. Of the reregistered population, 52.8% were women, 62.5% were aged between 15 and 59 years and 60.0% declared themselves white. Among respondents aged 15 or over, 90.0% had completed elementary school. The main occupation was "formal salaried job". Additionally, 18.6% of the interviewees declared themselves to be hypertensive and 7.0%, diabetic. Conclusions: The reregistration process uncovered relevant information to support both PHC planning as well as social assistance, work and housing initiatives; it was also fundamental to define health care strategies in this border town during the COVID-19 pandemic.

Objetivo: Presentar la experiencia y los resultados de la reinscripción de la población residente en Foz do Iguaçu, un municipio fronterizo ubicado en el estado de Paraná (Brasil), en cumplimiento de las directrices de la Política de atención primaria de salud y su nuevo modelo de financiamiento (Programa Previne Brasil). Métodos: Utilizando una estrategia de barrido (muestreo de conveniencia) para la recolección de datos, se visitaron 52 263 hogares y se realizaron 22 710 entrevistas entre septiembre y noviembre de 2019. Las entrevistas fueron presenciales y estuvieron a cargo de 54 trabajadores comunitarios de salud. Se recopilaron datos sobre el hogar (régimen de propiedad de la vivienda, ubicación en una zona urbana o rural, tipo de vivienda, material de construcción, disponibilidad de redes de energía eléctrica y alcantarillado, abastecimiento de agua y eliminación de desechos) e información sobre la composición demográfica y la salud de los residentes. Resultados: La reinscripción reveló que los residentes eran propietarios de sus viviendas y que estas se encontraban ubicadas en zonas urbanas, estaban bien construidas y tenían servicios de energía eléctrica, abastecimiento de agua y recolección de basura. El 52,8% de la población registrada correspondió a mujeres, el 62,5% tenía entre 15 y 59 años y el 60,0% declaró que era de raza blanca. El 90,0% de los entrevistados mayores de 15 años había terminado la escuela primaria. La ocupación principal era "persona asalariada con carnet de trabajo". Además, el 18,6% de los entrevistados indicó que tenía hipertensión y el 7,0%, diabetes. Conclusiones: La reinscripción aportó información relevante para apoyar la planificación de la atención primaria de salud , así como las iniciativas en materia de asistencia social, trabajo y vivienda; también fue fundamental para definir las estrategias de atención de salud en ese municipio fronterizo durante la pandemia de COVID-19.

Recadastramento da população residente em Foz do Iguaçu, Brasil, em atendimento à Política de Atenção Primária à Saúde

[RESUMO]. Objetivo. Apresentar a experiência e os resultados do recadastramento da população residente em Foz do Iguaçu, um município de fronteira localizado no estado do Paraná, Brasil, para atender às diretrizes da Política de Atenção Primária à Saúde (APS) e ao seu novo modelo de financiamento pelo Programa Previne Brasil. Métodos. Utilizando uma estratégia de varredura (amostra de conveniência) para coleta de dados, foram visitados 52 263 domicílios e realizadas 22 710 entrevistas de setembro a novembro de 2019. As entrevis- tas foram realizadas pessoalmente por 54 agentes comunitários de saúde. Foram coletados dados sobre o domicílio (status de posse da moradia, localização urbana ou rural, tipo de domicílio, material da construção, disponibilidade de rede elétrica e de esgoto, abastecimento de água e destino do lixo) e informações demo- gráficas e de saúde dos moradores. Resultados. O recadastramento revelou que os domicílios eram predominantemente casas próprias, em área urbana, bem edificados e servidos por energia elétrica, rede geral de água e coleta de lixo. Sobre a popu- lação recadastrada, 52,8% eram mulheres, 62,5% tinham idade de 15 a 59 anos e 60,0% se autodeclararam brancos. Entre os entrevistados com 15 anos ou mais, 90,0% tinham completado o ensino fundamental. A principal ocupação foi “assalariado com carteira de trabalho”. Ainda, 18,6% dos entrevistados se autodecla- raram hipertensos e 7,0%, diabéticos. Conclusões. O recadastramento trouxe informações relevantes para subsidiar o planejamento da APS, assim como iniciativas de assistência social, trabalho e habitação; também foi fundamental para definir estratégias de atenção à saúde nesse município de fronteira durante a pandemia de COVID-19.

[ABSTRACT]. Objective. To present the experience and results of the reregistration of residents in Foz do Iguaçu, a border town located in the state of Paraná, Brazil, to meet the guidelines of the national Primary Health Care (PHC) Policy and its new financing model (Programa Previne Brasil). Method. A scanning strategy (convenience sample) was used for data collection, with 52263 households visited and 22 710 interviews conducted from September to November 2019. The interviews were conducted face-to-face by 54 community health workers. Data were collected on the household (ownership status, urban or rural location, type of household, construction material, availability of electrical and sewage networks, water supply and waste disposal). Demographic and health information on the residents was also collected. Results. The reregistration process revealed that most residents were home owners and lived in well-cons- tructed homes, located mostly in urban areas, served by electricity, with access to water supply and garbage collection. Of the reregistered population, 52.8% were women, 62.5% were aged between 15 and 59 years and 60.0% declared themselves white. Among respondents aged 15 or over, 90.0% had completed elemen- tary school. The main occupation was “formal salaried job”. Additionally, 18.6% of the interviewees declared themselves to be hypertensive and 7.0%, diabetic. Conclusions. The reregistration process uncovered relevant information to support both PHC planning as well as social assistance, work and housing initiatives; it was also fundamental to define health care strategies in this border town during the COVID-19 pandemic.

[RESUMEN]. Objetivo. Presentar la experiencia y los resultados de la reinscripción de la población residente en Foz do Iguaçu, un municipio fronterizo ubicado en el estado de Paraná (Brasil), en cumplimiento de las directrices de la Política de atención primaria de salud y su nuevo modelo de financiamiento (Programa Previne Brasil). Métodos. Utilizando una estrategia de barrido (muestreo de conveniencia) para la recolección de datos, se visitaron 52 263 hogares y se realizaron 22 710 entrevistas entre septiembre y noviembre de 2019. Las entrevistas fueron presenciales y estuvieron a cargo de 54 trabajadores comunitarios de salud. Se recopilaron datos sobre el hogar (régimen de propiedad de la vivienda, ubicación en una zona urbana o rural, tipo de vivienda, material de construcción, disponibilidad de redes de energía eléctrica y alcantarillado, abasteci- miento de agua y eliminación de desechos) e información sobre la composición demográfica y la salud de los residentes. Resultados. La reinscripción reveló que los residentes eran propietarios de sus viviendas y que estas se encontraban ubicadas en zonas urbanas, estaban bien construidas y tenían servicios de energía eléctrica, abastecimiento de agua y recolección de basura. El 52,8% de la población registrada correspondió a mujeres, el 62,5% tenía entre 15 y 59 años y el 60,0% declaró que era de raza blanca. El 90,0% de los entre- vistados mayores de 15 años había terminado la escuela primaria. La ocupación principal era “persona asalariada con carnet de trabajo”. Además, el 18,6% de los entrevistados indicó que tenía hipertensión y el 7,0%, diabetes. Conclusiones. La reinscripción aportó información relevante para apoyar la planificación de la atención pri- maria de salud , así como las iniciativas en materia de asistencia social, trabajo y vivienda; también fue fundamental para definir las estrategias de atención de salud en ese municipio fronterizo durante la pandemia de COVID-19.

Valorization of Phenolic and Carotenoid Compounds of Sechium edule (Jacq. Swartz) Leaves: Comparison between Conventional, Ultrasound- and Microwave-Assisted Extraction Approaches.

Chayote leaves are known for culinary and traditional medicine applications. This work intended to recover carotenoids and phenolic compounds from chayote leaves using the ultrasound-assisted extraction (UAE). A Box-Behnken design was employed to investigate the impact of extraction time, temperature, and ultrasonic power on the recovery of total carotenoids, total phenolic compounds, and antioxidant activities. For comparative purposes, chayote leaf extracts were prepared by maceration (ME) and microwave-assisted extraction (MAE), using the same time and temperature conditions optimized by UAE. Extraction at 50 °C and 170 Watts for 30 min provided the optimal UAE conditions. UAE showed better extraction efficacy than ME and MAE. The HPLC analysis of the extracts showed that the xanthophyll class was the main class of carotenoids, which constituted 42-85% of the total carotenoid content, followed by ß-carotene and tocopherol. Moreover, 26 compounds, classified as phenolic acids, flavonols, flavonoids and other polar compounds, were identified in the chayote leaf extracts. Flavonols accounted for 55% of the total compounds quantified (the major compound was myricetin) and phenolic acids represented around 35%, mostly represented by ferulic acid, chlorogenic acid and (+)-catechin. This study revealed the potential of UAE as an effective green extraction technique to recover bioactive compounds from chayote leaves, for food, and for pharmaceutical and cosmetic applications.

Leaf surfaces and neolithization - the case of Arundo donax L.

Arundo donax L. (Arundinoideae subfamily, Poaceae family) is a sub-tropical and temperate climate reed that grows in arid and semi-arid environmental conditions, from eastern China to the Mediterranean basin, suggesting potential adaptations at the epicuticular level. A thorough physical-chemical examination of the adaxial and abaxial surfaces of A. donax leaf was performed herein in an attempt to track such chemophenetic adaptations. This sort of approach is of the utmost importance for the current debate about the hypothetical invasiveness of this species in the Mediterranean basin versus its natural colonization along the Plio-Pleistocene period. We concluded that the leaf surfaces contain, apart from stomata, prickles, and long, thin trichomes, and silicon-rich tetralobate phytolits. Chemically, the dominating elements in the leaf ashes are oxygen and potassium; minor amounts of calcium, silicon, magnesium, phosphorous, sulphur, and chlorine were also detected. In both surfaces the epicuticular waxes (whose density is higher in the adaxial surface than in the abaxial surface) form randomly orientated platelets, with irregular shape and variable size, and aggregated rodlets with variable diameter around the stomata. In the case of green mature leaves, the dominating organic compounds of the epicuticular waxes of both surfaces are triterpenoids. Both surfaces feature identical hydrophobic behaviour, and exhibit the same total transmittance, total reflectance, and absorption of incident light. The above findings suggest easy growth of the plant, remarkable epidermic robustness of the leaf, and control of water loss. These chemophenetic characteristics and human influence support a neolithization process of this species along the Mediterranean basin.

Effects of Seed Roasting Temperature on Sesame Oil Fatty Acid Composition, Lignan, Sterol and Tocopherol Contents, Oxidative Stability and Antioxidant Potential for Food Applications.

Roasting is a key step for preparing sesame oil that leads to important changes in its organoleptic properties and quality. In this study, white sesame seeds were roasted for 20 min in an electric oven at different temperatures (120, 150, 180, 210, 250 and 300 °C). The oils extracted from unroasted and roasted seeds were compared for their chemical composition: fatty acids (including trans isomers), phytosterols, lignans (sesamin and sesamolin), tocopherols and total phenolic compounds, as well as their oxidative stability and antiradical capacity. There were no obvious differences in the oil densities, refractive indexes or iodine values, but the saponification values were affected by temperature. Relevant primary and secondary lipid oxidation were observed at T > 250 °C, resulting in a higher p-anisidine value and K232 as well as K268 values. Roasting improved oil yield (from 33.5 to 62.6%), increased its induction period (from 5.5 to 10.5 h) and enhanced the total phenolic content (from 152 to 194 mg/100 g) and antiradical activity of the extracted oil. Depending on roasting temperature, a gradual decline was recorded in total amounts of phytosterols (up to 17.4%), γ-tocopherol (up to 10.6%), sesamolin (maximum of 27.5%) and sesamin (maximum of 12.5%). All the investigated oils presented a low quantity in triglyceride polymers, clearly below the maximum tolerated quantity according to the European regulation. The optimal roasting temperature for obtaining high nutritional grade oil within the permissible values was 210 °C. The unsaponifiable components (including lignans and sterols) extracted from roasted seeds have been shown to be natural additives to fresh meatball products to extend shelf life. The results of this study may help to boost the nutritional content of plant-based diets by allowing for the use of roasted sesame seed oil and its components.

Vicariance Between Cercis siliquastrum L. and Ceratonia siliqua L. Unveiled by the Physical-Chemical Properties of the Leaves' Epicuticular Waxes.

Classically, vicariant phenomena have been essentially identified on the basis of biogeographical and ecological data. Here, we report unequivocal evidences that demonstrate that a physical-chemical characterization of the epicuticular waxes of the surface of plant leaves represents a very powerful strategy to get rich insight into vicariant events. We found vicariant similarity between Cercis siliquastrum L. (family Fabaceae, subfamily Cercidoideae) and Ceratonia siliqua L. (family Fabaceae, subfamily Caesalpinoideae). Both taxa converge in the Mediterranean basin (C. siliquastrum on the north and C. siliqua across the south), in similar habitats (sclerophyll communities of maquis) and climatic profiles. These species are the current representation of their subfamilies in the Mediterranean basin, where they overlap. Because of this biogeographic and ecological similarity, the environmental pattern of both taxa was found to be very significant. The physical-chemical analysis performed on the epicuticular waxes of C. siliquastrum and C. siliqua leaves provided relevant data that confirm the functional proximity between them. A striking resemblance was found in the epicuticular waxes of the abaxial surfaces of C. siliquastrum and C. siliqua leaves in terms of the dominant chemical compounds (1-triacontanol (C30) and 1-octacosanol (C28), respectively), morphology (intricate network of randomly organized nanometer-thick and micrometer-long plates), wettability (superhydrophobic character, with water contact angle values of 167.5 ± 0.5° and 162 ± 3°, respectively), and optical properties (in both species the light reflectance/absorptance of the abaxial surface is significantly higher/lower than that of the adaxial surface, but the overall trend in reflectance is qualitatively similar). These results enable us to include for the first time C. siliqua in the vicariant process exhibited by C. canadensis L., C. griffithii L., and C. siliquastrum.

Does water addition during the industrial milling phase affect the chemical-sensory quality of olive oils? The case of cv. Arbequina oils.

At olive oil industrial extraction, water addition is a practice overcoming the formation of thick pastes. The effect of water addition (0 to 6.2%, kgadded water/kgolives), during the industrial milling of cv. Arbequina olives, on the oils' chemical-sensory quality, was evaluated. Despite the extra virgin olive oil classification, compared with the water incorporation (1.2-6.2%), extraction without water addition resulted into oils that showed less primary oxidation (lower peroxide values and K232), greater total phenolic content (+12-22%) and higher oxidative stability (+22-31%). No water addition increased the oils secoiridoids content (+5-13%), mainly oleacein (+27-79%). Oils extracted without water addition had a more intense ripe fruity sensation (≥ +11%) but lower fruit intensities (at least -4%). Thus, the quality and stability of the cv. Arbequina oils can be favoured if extracted without adding water during the olives industrial milling.

Impact of fresh olive leaves addition during the extraction of Arbequina virgin olive oils on the phenolic and volatile profiles.

Leaves incorporation during the extraction of olive oils can enhance their chemical-sensory quality. Thus, leaves from cvs. Arbequina or Santulhana were added (1%, w/w) during the extraction of Arbequina oils using an Abencor system, being discussed the impacts on the phenolics and volatiles formation enzymatic pathways. Leaves addition contributed to a significant decrease (P-value < 0.05) of the contents of secoiridoids (-11%), C6-aldehydes (-16%), and ester compounds (-22%). This could be tentatively related to a reduction of the enzymatic activity of secoiridoids biosynthesis and lipoxygenase pathways, promoted by the leaves' addition. Moreover, in the presence of leaves, the oils' total contents of phenolics and volatiles were significantly reduced (-7 and -17%, respectively). Contrary, the incorporation of leaves significantly increased (P-value < 0.05) the contents of C6-alcohols (+37%) and the intensities of the green fruity (+25%) and apple (+30%) sensations.

Blood pressure variability in individuals with diabetes mellitus: a scoping review.

OBJECTIVES: to map methods and devices used to assess very short-, short-, medium-, and long-term pressure variability in adults with type 1 or 2 diabetes mellitus. METHODS: scoping review conducted in January and February 2021 in MEDLINE, Web of Science, CINAHL, LILACS, PubMed, and Embase databases. Studies conducted within the last ten years analyzing pressure variability in adult and older patients with diabetes mellitus type 1 or 2 were included. Studies that used discontinued devices were excluded. RESULTS: the sample was composed of 25 articles published since 2017, with the majority developed in Japan (n=11); with the predominance of the oscillometric method (n=22); the most used devices were from the Omron® brand (n=14); the most detected type was long-term variability (n=10). CONCLUSIONS: we observed the increasing application of the oscillometric method for pressure variability analysis with various brands and models of automatic devices.

Safety and Quality of Canned Sardines after Opening: A Shelf-Stability Study.

This study aimed to define the shelf life of canned sardines after opening to increase consumer awareness of their quality and safety and reduce food waste. For this purpose, canned sardines (Sardina pilchardus) packed with different sauces were opened and stored at 4 °C for 7 days. Microbiological, sensorial, physical and chemical stability was monitored daily by standard methodologies. Results show that the overall quality and safety are highly dependent on the sauce type. To preserve their full quality, sardines in brine and in vegetable oil should be consumed up to 1 day after opening, while sardines in tomato sauce were stable for up to 3 days, although none were considered nonedible up to the 7th day. Many parameters demonstrated statistical differences and correlations with storage, although they were not as decisive as sensory evaluation. This integrated approach should be adopted by the food industry and regulating authorities to provide information to consumers regarding the quality and safety of handled goods.

Chemical Characterization of the Oil Separated by Mechanical Pressing from Strychnos madagascariensis Dried Fruit Pulp Flour.

In Mozambique, rural communities produce flours from the dried pulp of Strychnos madagascariensis fruits. Owing to its high lipid content, the oil from this flour is frequently separated by pressing to be used as seasoning and medicine. Aiming to characterize this oil, flour samples (n = 24), dried at two different temperatures (55 °C and 65 °C), were collected from four local communities, together with a control sample prepared in the lab (50 °C). The resulting oil was fluid at room temperature, deep orange, and characterized by a high content of oleic acid (62-63%), followed by palmitic (20%) and linoleic (7%). It contained considerable amounts of tocols (25-34 mg/100 g) and carotenoids (8-10 mg/100 g), as well as sterols (431 ± 10 mg/100 g) and triterpenic alcohols (823 ± 4 mg/100 g mg/100 g). The overall composition was highly consistent between origins and temperatures, with only small statistically significant differences (p < 0.05), mostly between the community dried flours and control group. However, its high free fatty acid content (22-25%) reveals intensive enzymatic hydrolysis during the drying/fermentation steps, whose extension can be reduced by optimizing its technological process. Its chemical profile supports some of its folklore uses, revealing that it can be a promising source of edible oil, with health and technological potential that is worth optimizing and exploring.

Analysis of payment models applied to federal funding from the perspective of the Brazilian Health System

Objective: This study aims at identifying the payment methods existing in the Unified Health System referring to federal transfers to Primary Health Care (PHC) and Specialized Health Care. Methods: A quantitative and analytical study was carried out, developed in three stages: survey of all types of transfers from the Union; classification of each transfer category according to the types of payment methods and measurement of the participation of each payment methods, according to the financing components analyzed, in relation to the net values transferred. Results: Federal transfers were classified into seven payment methods. For PHC, in 2020, approximately R$ 21.7 billion was calculated, including resources destined for the pandemic, and R$ 20.9 billion without considering resources to face the COVID-19 pandemic. More than 50% of the amounts used were classified as capitation, in both cases. For specialized health care, in 2019, around R$ 48.5 billion were calculated, and in 2020 more than R$ 49.2 billion. For the two years, more than 70% of the funds were allocated to fee for service. Conclusions: This study allowed for an expansion in knowledge about the allocation of resources referring to transfers from the Union to states, the Federal District and municipalities. As the payment methods are related to productivity, access and quality of the health service, knowing and identifying the most appropriate payment methods for each situation contributes to the achievement of the goals and to the mitigation of eventual losses of efficiency in the healthcare systems.

Análise dos modelos de pagamento aplicados ao financiamento federal na perspectiva do Sistema Único de Saúde / Analysis of payment models applied to federal funding from the perspective of the Brazilian Health System

Objetivo: Este estudo tem por objetivo identificar os modelos de pagamento existentes no Sistema Único de Saúde referentes aos repasses federais para a Atenção Primária à Saúde (APS) e a Atenção Especializada à Saúde. Métodos: Foi realizado um estudo quantitativo e analítico, desenvolvido em três etapas: levantamento de todos os tipos de repasse da União; classificação de cada categoria de repasse segundo os tipos de modelos de pagamentos; e mensuração da participação de cada modelo de pagamento, de acordo com os componentes de financiamento analisados, em relação aos valores líquidos repassados. Resultados: Os repasses federais foram classificados em sete modelos de pagamentos. Para a APS, em 2020, foram apurados R$ 21,7 bilhões, aproximadamente, incluindo os recursos destinados para a pandemia, e R$ 20,9 bilhões, sem considerar os recursos para enfrentamento da pandemia de COVID-19. Mais de 50% dos valores empregados foram classificados como capitação, em ambos os casos. Para a Atenção Especializada à Saúde, em 2019, foram computados em torno de R$ 48,5 bilhões e, em 2020, acima de R$ 49,2 bilhões. Para os dois anos, mais de 70% dos recursos foram destinados a pagamentos por procedimento. Conclusões: Este estudo permitiu a ampliação do conhecimento sobre a alocação dos recursos referentes aos repasses da União para estados, Distrito Federal e municípios. Como os modelos de pagamentos estão relacionados com a produtividade, acesso e qualidade do serviço de saúde, conhecer as formas de pagamento e identificar a mais adequada para cada situação contribui para o alcance das metas e para a mitigação de eventuais perdas de eficiência nos sistemas de saúde.

Objective: This study aims at identifying the payment methods existing in the Unified Health System referring to federal transfers to Primary Health Care (PHC) and Specialized Health Care. Methods: A quantitative and analytical study was carried out, developed in three stages: survey of all types of transfers from the Union; classification of each transfer category according to the types of payment methods and measurement of the participation of each payment methods, according to the financing components analyzed, in relation to the net values transferred. Results: Federal transfers were classified into seven payment methods. For PHC, in 2020, approximately R$ 21.7 billion was calculated, including resources destined for the pandemic, and R$ 20.9 billion without considering resources to face the COVID-19 pandemic. More than 50% of the amounts used were classified as capitation, in both cases. For specialized health care, in 2019, around R$ 48.5 billion were calculated, and in 2020 more than R$ 49.2 billion. For the two years, more than 70% of the funds were allocated to fee for service. Conclusions: This study allowed for an expansion in knowledge about the allocation of resources referring to transfers from the Union to states, the Federal District and municipalities. As the payment methods are related to productivity, access and quality of the health service, knowing and identifying the most appropriate payment methods for each situation contributes to the achievement of the goals and to the mitigation of eventual losses of efficiency in the healthcare systems.