A multistate model and its standalone tool to predict hospital and ICU occupancy by patients with COVID-19.

Objective: This study aims to build a multistate model and describe a predictive tool for estimating the daily number of intensive care unit (ICU) and hospital beds occupied by patients with coronavirus 2019 disease (COVID-19). Material and methods: The estimation is based on the simulation of patient trajectories using a multistate model where the transition probabilities between states are estimated via competing risks and cure models. The input to the tool includes the dates of COVID-19 diagnosis, admission to hospital, admission to ICU, discharge from ICU and discharge from hospital or death of positive cases from a selected initial date to the current moment. Our tool is validated using 98,496 cases positive for severe acute respiratory coronavirus 2 extracted from the Aragón Healthcare Records Database from July 1, 2020 to February 28, 2021. Results: The tool demonstrates good performance for the 7- and 14-days forecasts using the actual positive cases, and shows good accuracy among three scenarios corresponding to different stages of the pandemic: 1) up-scenario, 2) peak-scenario and 3) down-scenario. Long term predictions (two months) also show good accuracy, while those using Holt-Winters positive case estimates revealed acceptable accuracy to day 14 onwards, with relative errors of 8.8%. Discussion: In the era of the COVID-19 pandemic, hospitals must evolve in a dynamic way. Our prediction tool is designed to predict hospital occupancy to improve healthcare resource management without information about clinical history of patients. Conclusions: Our easy-to-use and freely accessible tool (https://github.com/peterman65) shows good performance and accuracy for forecasting the daily number of hospital and ICU beds required for patients with COVID-19.

Evaluation of grape stems and grape stem extracts for sulfur dioxide replacement during grape wine production.

Sulfur dioxide (SO2), the main preservative in wine, may affect the sensory properties of the wines, as well as cause allergic reactions and headaches in sensitive people. The aim of this work was to evaluate the replacement of SO2 in Tempranillo wines with Mazuelo grape stem products. Five Tempranillo red wines were elaborated: positive control (60 mg/L SO2); negative control with no preservatives; Mazuelo extract (200 mg/L); Mazuelo extract combined with SO2 (100 mg/L + 20 mg/L); and Mazuelo stem (400 mg/L). The oenological parameters, antioxidant capacity, total phenolic (TP), total flavonoids (TF) and total anthocyanins (TA) contents were determined. Additionally, individual phenols were analyzed by HPLC-DAD-FLD. The spectrophotometric analyses showed that the wines had similar antioxidant capacities and concentrations of TP and TF. However, TA was more affected by the lack of SO2 as anthocyanins presented higher concentrations in positive control samples. The concentrations of individual phenols followed a similar path in all samples. Wines containing sulfites were more similar than the other treatments. However, these similarities were not reflected on the sensory analysis performed, as triangle test did not show differences between the wine with extract addition and the positive control wine. Therefore, Mazuelo stem extract could be a possible strategy for SO2 replacement. Nevertheless, further studies are necessary to confirm the potential of grape stem extracts as wine preservative.

Valorization of agri-food waste through the extraction of bioactive molecules. Prediction of their sunscreen action.

The aim of this work was to identify the phenolic composition of 18 different vegetable residues and to determine the relationship between their phenolic compounds, antioxidant capacity and sun protection factor. For this purpose, samples of agri-food residues were analyzed to quantify their antioxidant capacity, total polyphenol and flavonoid content, sun protection factor and individual phenolic compounds through HPLC-DAD-FLD. Among the different phenolic compounds found in the extracts, the phenolic acids, especially caffeic acid, chlorogenic acid, p-coumaric acid and protocatechuic acid were the ones that have been most frequently identified, and, therefore, are present in a wide range of extracts. Black chai tea, lemon ginger tea and peanut extracts were the most antioxidant and photoprotective extracts. Phenolic compounds in the extracts have been found to contribute to their antioxidant activity and are closely correlated to their photoprotective capacity. A regression model that allows predicting the photoprotective capacity of any extract based on its total phenol content has been developed as a tool to determine the most suitable industrial application for each vegetable extract.

Phenolic Composition of Grape Stems from Different Spanish Varieties and Vintages.

Grape stems are a by-product from the wine industry that has been underused to date despite having great potential for the agro-food and cosmetic industries. The aim of the present work was to characterize grape stem extracts obtained from different grape varieties from two vintages (2016 and 2018). Both spectrophotometric and chromatographic methods were used for sample characterization. The results showed that there exist significant differences in antioxidant activity, total phenolic content (TPC) and total flavonoid content (TF) among grape stems from different varieties in each vintage and from different vintage for the same variety. Catechin was the most abundant phenolic compound in all extracts from both vintages. In general, Mazuelo presented higher concentration values of the different phenolic compounds than Garnacha and Tempranillo. It was observed than extreme temperatures and accumulated precipitations, which were higher in the 2016 vintage, had an impact on the polyphenol synthesis. Therefore, grape stems from the 2018 vintage presented higher TPC and TF values than their counterparts from the 2016 vintage. In addition, the statistical analysis revealed that the influence of environmental factor such as light, temperature and precipitations have different impact on the synthesis of polyphenols depending on the family of the specific compound.

Reducing SO2 Doses in Red Wines by Using Grape Stem Extracts as Antioxidants.

SO2 is a very important wine preservative. However, there are several drawbacks associated with the use of SO2 in wine. The aim of this work is to evaluate the effect of the partial substitution of SO2 in the Tempranillo wine by a Mazuelo grape stem extract and by a commercial vine wood extract (Vinetan®). The results were compared with a control sample (with no addition of any extract). After 12 months of storage in a bottle, total anthocyanin content, together with total polyphenol and flavonoid content were slightly higher for control wines than for those treated with extracts. These differences were of little relevance, as no differences in antioxidant activity were found between any of the wines at the end of the study. The sensory analysis revealed that the use of both extracts as partial substitutes of SO2 could lead to wines with good organoleptic properties, similar or even better to the control ones.

Stability of Phenolic Compounds in Grape Stem Extracts.

Grape stem is rich in phenolic compounds, especially stilbenes. These antioxidants can be degraded during the storage of grape stem extracts for long periods of time. The aim of this work was to analyze the stability of Mazuelo stem extracts during storage at 25 and 40 °C, in two different light conditions (amber and transparent vials). The stability of the antioxidants was studied after 2, 4 and 6 months of conservation. Gallic acid and the quercetin derivative concentration were stable throughout the storage period. In contrast, catechin disappeared from all the extracts in just two months of storage. Anthocyanins were significantly affected by temperature, and light enhanced their degradation when the extracts were kept at 40 °C. Resveratrol and viniferin showed a similar behavior. Their concentration decreased from the beginning of storage, and in both cases, they were significantly affected by both temperature and light.

Psychosocial Adjustment of In-Home Caregivers of Family Members with Dementia and Parkinson's Disease: A Comparative Study.

Neurodegenerative diseases such as Parkinson's and dementia are highly prevalent worldwide. People who suffer from these disorders often receive in-home care and assistance from family members, who must dedicate a considerable amount of time to the care recipient. The study of family caregivers' psychosocial adjustment to the degenerative processes of both conditions is of interest due to the implications for the quality of life of both the care receiver and the caregiver, as well as other family members. This study compares the psychosocial adjustment of family members who care for people with dementia and Parkinson's disease and identifies the main sociodemographic variables that affect the processes of adjustment to both conditions. To this end, the Psychosocial Adjustment to Illness Scale (PAIS-SR) and a sociodemographic form were administered to 157 family caregivers in Navarre, Spain. The results show that adjustment to the disease in family caregivers of people with Parkinson's disease and dementia is, in general, satisfactory and related to variables such as place of residence, income, and employment status. The illness itself (Parkinson's or dementia), however, is found to be the most influential variable in the level of psychosocial adjustment.

Foliar application of urea to Tempranillo vines increased the amino acid concentration of the must.

The aim of this study was to investigate the impact of fertilisation with foliar urea of Vitis vinifera var. Tempranillo on the concentration of amino acids in must and on their evolution during the final stage of grape ripening. Foliar urea fertilisation increased the concentration of amino nitrogen, ammonium nitrogen and yeast assimilable nitrogen (YAN) in Tempranillo must. In addition, fertilisation with foliar urea produced an increase in the concentration of many amino acids in the must. This increase was especially noticeable in the case of the most important amino acids for yeast metabolism throughout the alcoholic fermentation (arginine, glutamic acid, aspartic acid, histidine, serine and lysine). After comparing the results of this study with other ones, we may state that: in order to increase the amino acid concentration in must, it is important to apply the urea several times instead of making just one single application. Moreover, it is important to use a preparation of urea without biuret, which is a phytotoxic carbamyl urea formed as a condensation product arising from urea thermal decomposition.

Impact of Extraction Conditions on the Phenolic Composition and Antioxidant Capacity of Grape Stem Extracts.

The use of grape stems for the extraction of bioactive compounds to be used in the pharmaceutical, food, and cosmetic industries is a promising objective. The aim of this work is to determine the influence of the different extraction conditions (temperature, ethanol concentration, and ratio of sample/solvent) on phenolic composition and antioxidant capacity of Mazuelo stem extracts. In general, the ethanol concentration of the extraction solvent was the factor that had the greatest influence on the extraction of different bioactive compounds. The greatest content of total phenolic compounds and the highest antioxidant activity of the extracts were obtained with 50% ethanol and at 40 °C. The most abundant compound found in the different extracts obtained from Mazuelo grape stem was (+)-catechin, but appreciable concentrations of gallic acid, a quercetin derivative, and stilbenes (trans-resveratrol and trans-ε-viniferin) were also extracted. Quercetin and malvidin-3-glucoside showed the highest correlation with the antioxidant capacity of the extracts, while stilbenes did not present such relation. The maximum concentration of gallic acid was extracted with water but the extraction of most of the compounds was maximum on using 50% ethanol. Consequently, the selection of the extraction method to be used will depend on the particular compound to be extracted in greatest quantity.

Oak wood extracts applied to the grapevine. An alternative to obtain quality Garnacha wines.

Stomata in leaves regulate gas interchange and transpiration in the grapevine and through these pores both the penetration of aqueous solutions with nutrients as well as the excretion of products take place. The aim of this work was to study the influence of spraying the vineyard with toasted and untoasted oak extracts on the volatile composition and on the organoleptic quality of wine made from Garnacha grapes. The results were compared with a Garnacha control wine obtained with grapes sprayed with distilled water. The absorption of the compounds from the oak wood extracts was irregular and some of these compounds were modified by the yeast during fermentation so as to prevent fermentation problems. This was observed particularly in the case of furfural which were transformed into furfuryl alcohol by yeast in order to avoid irreversible cellular damage. On applying a discriminant analysis to the concentration of volatile compounds in the wines, the three treatments (control, toasted and untoasted oak extracts) were differentiate. The wine obtained from grapes treated with toasted oak extract showed a more intense wood aroma after 18months of bottle aging than the other wines. Likewise, spicy aromas were found to be more intense in the samples treated with some type of oak wood extracts.

Effects of reduced levels of sulfite in wine production using mixtures with lysozyme and dimethyl dicarbonate on levels of volatile and biogenic amines.

Sulphur dioxide (SO2) is an important preservative for wine, but its presence in foods can cause allergies and this has given impetus to the research for alternatives. The aim of this study was to reduce levels of sulfite in wine production using mixtures with lysozyme and dimethyl dicarbonate and examine the influence on levels of volatile and biogenic amines. To do so, vinifications were carried out using lysozyme, dimethyl dicarbonate (DMDC) and mixtures of these with SO2 in different concentrations (25 and 50 mg l-1). Results were compared with a control vinification with only SO2 (50 mg l-1). Mixing low concentrations of SO2 with lysozyme and DMDC reduced the concentration of biogenic amines (histamine, tyramine, putrescine, cadaverine, phenylethylamine + spermidine and spermine). In general, the total concentration of volatile amines (dimethylamine, isopropylamine, isobutylamine, pyrrolidine, ethylamine, diethylamine, amylamine and hexylamine) was higher in the sample fermented only with SO2. The concentrations of amines with secondary amino groups (dimethylamine, diethylamine, pyrrolidine) were higher in the sample only fermented with SO2 than those fermented with DMDC and lysozyme or with a mixture of preservatives. When SO2 was the only preservative in wine, total amine concentration (biogenic and volatile amines) was higher than for the rest of the treatments. Lysozyme by itself, and lysozyme mixed with SO2, both reduced the formation of biogenic amines but given the antioxidant activity of SO2 the use of the preservative mixture seems more advisable.