Neighborhood Walkability Is Associated With Lower Burden of Cardiovascular Risk Factors Among Cancer Patients.

Background: Modifiable cardiovascular risk factors constitute a significant cause of cardiovascular disease and mortality among patients with cancer. Recent studies suggest a potential link between neighborhood walkability and favorable cardiovascular risk factor profiles in the general population. Objectives: This study aimed to investigate whether neighborhood walkability is correlated with favorable cardiovascular risk factor profiles among patients with a history of cancer. Methods: We conducted a cross-sectional study using data from the Houston Methodist Learning Health System Outpatient Registry (2016-2022) comprising 1,171,768 adults aged 18 years and older. Neighborhood walkability was determined using the 2019 Walk Score and divided into 4 categories. Patients with a history of cancer were identified through International Classification of Diseases-10th Revision-Clinical Modification codes (C00-C96). We examined the prevalence and association between modifiable cardiovascular risk factors (hypertension, diabetes, smoking, dyslipidemia, and obesity) and neighborhood walkability categories in cancer patients. Results: The study included 121,109 patients with a history of cancer; 56.7% were female patients, and 68.8% were non-Hispanic Whites, with a mean age of 67.3 years. The prevalence of modifiable cardiovascular risk factors was lower among participants residing in the most walkable neighborhoods compared with those in the least walkable neighborhoods (76.7% and 86.0%, respectively). Patients with a history of cancer living in very walkable neighborhoods were 16% less likely to have any risk factor compared with car-dependent-all errands neighborhoods (adjusted OR: 0.84, 95% CI: 0.78-0.92). Sensitivity analyses considering the timing of events yielded similar results. Conclusions: Our findings demonstrate an association between neighborhood walkability and the burden of modifiable cardiovascular risk factors among patients with a medical history of cancer. Investments in walkable neighborhoods may present a viable opportunity for mitigating the growing burden of modifiable cardiovascular risk factors among patients with a history of cancer.

Comparative Evaluation of Boron Sorption Dynamics on Zeolites in Irrigation Waters: An Isothermal Modeling Approach.

Efficient boron removal from irrigation waters is crucial for sustainable agriculture, as elevated levels of boron can be toxic to many plants, limiting growth and crop productivity. In this context, the present study investigated the sorption equilibrium of boron using zeolites in two types of aqueous matrices: a synthetic solution containing only boron and natural irrigation waters. Through the application of various isothermal sorption models (Langmuir, Freundlich, Sips, Toth, Jovanovic, Temkin, Dubinin-Radushkevich, and Redlich-Peterson), the efficacy of zeolite for boron removal under controlled and real conditions was evaluated. The results indicated a notable difference in sorption behavior between the two matrices, reflecting the complexity and heterogeneity of interactions in the boron-zeolite system. In the synthetic solution, the Freundlich model provided the best fit (R2 = 0.9917), suggesting heterogeneous and multilayer sorption, while the Sips model showed high efficacy in describing the sorption in both matrices, evidencing its capability to capture the complex nature of the interaction between boron and zeolite under different environmental conditions. However, in natural irrigation waters, the Jovanovic model demonstrated the most accurate fit (R2 = 0.999), highlighting the importance of physical interactions in boron sorption. These findings underscore the significant influence of the water matrix on the efficacy of zeolite as a boron removal agent, emphasizing the need to consider the specific composition of irrigation water in the design of removal treatments. Additionally, the results stress the importance of selecting the appropriate isothermal model to predict boron sorption behavior, which is crucial for developing effective and sustainable treatment strategies. This study provides a basis for optimizing boron removal in various agricultural and industrial applications, contributing to the design of more efficient and specific water treatment processes.

Houston Methodist cardiovascular learning health system (CVD-LHS) registry: Methods for development and implementation of an automated electronic medical record-based registry using an informatics framework approach.

Objectives: To investigate the potential value and feasibility of creating a listing system-wide registry of patients with at-risk and established Atherosclerotic Cardiovascular Disease (ASCVD) within a large healthcare system using automated data extraction methods to systematically identify burden, determinants, and the spectrum of at-risk patients to inform population health management. Additionally, the Houston Methodist Cardiovascular Disease Learning Health System (HM CVD-LHS) registry intends to create high-quality data-driven analytical insights to assess, track, and promote cardiovascular research and care. Methods: We conducted a retrospective multi-center, cohort analysis of adult patients who were seen in the outpatient settings of a large healthcare system between June 2016 - December 2022 to create an EMR-based registry. A common framework was developed to automatically extract clinical data from the EMR and then integrate it with the social determinants of health information retrieved from external sources. Microsoft's SQL Server Management Studio was used for creating multiple Extract-Transform-Load scripts and stored procedures for collecting, cleaning, storing, monitoring, reviewing, auto-updating, validating, and reporting the data based on the registry goals. Results: A real-time, programmatically deidentified, auto-updated EMR-based HM CVD-LHS registry was developed with ∼450 variables stored in multiple tables each containing information related to patient's demographics, encounters, diagnoses, vitals, labs, medication use, and comorbidities. Out of 1,171,768 adult individuals in the registry, 113,022 (9.6%) ASCVD patients were identified between June 2016 and December 2022 (mean age was 69.2 ± 12.2 years, with 55% Men and 15% Black individuals). Further, multi-level groupings of patients with laboratory test results and medication use have been analyzed for evaluating the outcomes of interest. Conclusions: HM CVD-LHS registry database was developed successfully providing the listing registry of patients with established ASCVD and those at risk. This approach empowers knowledge inference and provides support for efforts to move away from manual patient chart abstraction by suggesting that a common registry framework with a concurrent design of data collection tools and reporting rapidly extracting useful structured clinical data from EMRs for creating patient or specialty population registries.

Accurate Botanical Nomenclature: Pomegranate and the 'Aril' Misconception.

The pomegranate (Punica granatum L.) attracts attention in studies for its nutritional and medicinal properties. However, a recurring issue in the literature arises due to the multidisciplinary nature of these studies, leading to a mistaken repetition of basic botanical terms. The problem stems from the misapplication of the term "aril" to the pomegranate seed, despite the fruit being exariled, signifying the absence of an aril. This confusion may be attributed to the sarcotesta's appearance, resembling a complete aril, coupled with a lack of awareness in fields such as medicine, pharmacy, and cosmetics. This study specifically examines the Kingdom-variety pomegranate, due its economic importance in the fruit market. The fruits were evaluated at different developmental stages-initial, intermediate, and commercial. Magnification photography techniques were used to study the development state of the pomegranate fruits. The physiological studies confirm that the pomegranate seed constitutes the complete grain, with the juicy, sweet part surrounding it identified as the testa, not an aril. The findings underscore a persistent error in the existing literature, emphasizing the necessity for dissemination and education in future studies. A thorough grasp of pomegranate anatomy and precise use of terminology are indispensable for ensuring accuracy and rigor in scientific communication.

CLINICAL AND HEALTHCARE IMPACTS OF PORTABLE ULTRASONOGRAPHY IN AMBULATORY CARE MUSCULOSKELETAL REHABILITATION CONSULTATIONS.

Objective: We evaluated the impact of Point-of-care ultrasound (POCUS) in musculoskeletal consultations out of hospital using a Philips Lumify portable ultrasound device. We aimed to determine the impact of POCUS on the number of hospital referrals for injections as well as on the number of injections performed in consultation. Design: Retrospective case study comparing 2 periods: June to September 2021 (pre-POCUS) and November 2021 to February 2022 (POCUS). Statistical comparisons were performed using the χ2. In both periods, 21 medical consultations were performed. In the pre-POCUS period, 470 patients were assessed, with an average of 1.29 hospital referrals made per day of consultation for hospital injections and an average of 2.05 injections performed per day of medical consultation. In the POCUS period, 589 patients were assessed, with an average of 0.1 hospital referrals per day (-92.6%; p < 0.00001) and an average of 2.76 injections performed per day (+34.9%; p < 0.00001). The introduction of POCUS at our practice reduced the number of hospital referrals made for injections and increased the number of injections performed every day of consultation. Conclusion: This suggests that POCUS is of great clinical value in out-of-hospital musculoskeletal rehabilitation consultations.

Effects of marine sediment as agricultural substrate on soil microbial diversity: an amplicon sequencing study.

BACKGROUND: The soil microbiota has a direct impact on plant development and other metabolic systems, such as the degradation of organic matter and the availability of microelements and metabolites. In the context of agricultural soils, microbial activity is crucial for maintaining soil health and productivity. Thus, the present study aimed to identify, characterize, and quantify the microbial communities of four types of substrates with varying proportions of marine port sediment used for cultivating lemons. By investigating microbial diversity and relative abundance, the work aimed to highlight the importance of soil microbial communities in agriculture when alternative culture media was used. RESULTS: The composition and structure of the sampled microbial communities were assessed through the amplification and sequencing of the V3-V4 variable regions of the 16 S rRNA gene The results revealed a diverse microbial community composition in all substrate samples, with a total of 41 phyla, 113 classes, 266 orders, 405 families, 715 genera, and 1513 species identified. Among these, Proteobacteria, Bacteroidota, Planctomycetota, Patescibacteria, Chloroflexi, Actinobacteriota, Acidobacteriota, Verrucomicrobiota, and Gemmatimonadota accounted for over 90% of the bacterial reads, indicating their dominance in the substrates. CONCLUSIONS: The impact of the substrate origin on the diversity and relative abundace of the microbiota was confirmed. The higher content of beneficial bacterial communities for plant development identified in peat could explain why is considered an ideal agricultural substrate. Development of "beneficial for plants" bacterial communities in alternative agricultural substrates, regardless of the edaphic characteristics, opens the possibility of studying the forced and specific inoculation of these culture media aiming to be agriculturally ideals.

A Neuro-Informatics Pipeline for Cerebrovascular Disease: Research Registry Development.

BACKGROUND: Although stroke is well recognized as a critical disease, treatment options are often limited. Inpatient stroke encounters carry critical information regarding the mechanisms of stroke and patient outcomes; however, these data are typically formatted to support administrative functions instead of research. To support improvements in the care of patients with stroke, a substantive research data platform is needed. OBJECTIVE: To advance a stroke-oriented learning health care system, we sought to establish a comprehensive research repository of stroke data using the Houston Methodist electronic health record (EHR) system. METHODS: Dedicated processes were developed to import EHR data of patients with primary acute ischemic stroke, intracerebral hemorrhage (ICH), transient ischemic attack, and subarachnoid hemorrhage under a review board-approved protocol. Relevant patients were identified from discharge diagnosis codes and assigned registry patient identification numbers. For identified patients, extract, transform, and load processes imported EHR data of primary cerebrovascular disease admissions and available data from any previous or subsequent admissions. Data were loaded into patient-focused SQL objects to enable cross-sectional and longitudinal analyses. Primary data domains (admission details, comorbidities, laboratory data, medications, imaging data, and discharge characteristics) were loaded into separate relational tables unified by patient and encounter identification numbers. Computed tomography, magnetic resonance, and angiography images were retrieved. Imaging data from patients with ICH were assessed for hemorrhage characteristics and cerebral small vessel disease markers. Patient information needed to interface with other local and national databases was retained. Prospective patient outreach was established, with patients contacted via telephone to assess functional outcomes 30, 90, 180, and 365 days after discharge. Dashboards were constructed to provide investigators with data summaries to support access. RESULTS: The Registry of Neurological Endpoint Assessments among Patients with Ischemic and Hemorrhagic Stroke (REINAH) database was constructed as a series of relational category-specific SQL objects. Encounter summaries and dashboards were constructed to draw from these objects, providing visual data summaries for investigators seeking to build studies based on REINAH data. As of June 2022, the database contains 18,061 total patients, including 1809 (10.02%) with ICH, 13,444 (74.43%) with acute ischemic stroke, 1221 (6.76%) with subarachnoid hemorrhage, and 3165 (17.52%) with transient ischemic attack. Depending on the cohort, imaging data from computed tomography are available for 85.83% (1048/1221) to 98.4% (1780/1809) of patients, with magnetic resonance imaging available for 27.85% (340/1221) to 85.54% (11,500/13,444) of patients. Outcome assessment has successfully contacted 56.1% (240/428) of patients after ICH, with 71.3% (171/240) of responders providing consent for assessment. Responders reported a median modified Rankin Scale score of 3 at 90 days after discharge. CONCLUSIONS: A highly curated and clinically focused research platform for stroke data will establish a foundation for future research that may fundamentally improve poststroke patient care and outcomes.

Influence of Different Rootstocks on Fruit Quality and Primary and Secondary Metabolites Content of Blood Oranges Cultivars.

Blood oranges have high concentrations of bioactive compounds that are beneficial to health. In Europe, the cultivation of blood oranges is increasing due to their excellent nutritional properties. In Citrus crops, rootstocks play an important role in juice and can increase the content of bioactive compounds. The morphological, qualitative and nutritional parameters were analyzed in cultivars 'Tarocco Ippolito', 'Tarocco Lempso', 'Tarocco Tapi' and 'Tarocco Fondaconuovo' grafted onto Citrus macrophylla and Citrus reshni. 'Tarocco Lempso' grafted onto Citrus macrophylla obtained the highest values of weight (275.78 g), caliber (81.37 mm and 76.79 mm) and juice content (162.11 g). 'Tarocco Tapi' grafted onto Citrus reshni obtained the most interesting qualitative parameters (15.40 °Brix; 12.0 MI). 'Tarocco Lempso' grafted onto Citrus reshni obtained the most intense red juice (a* = 9.61). Overall, the highest concentrations of primary metabolites were in proline, aspartate, citric acid, and sucrose. The results showed that 'Tarocco Ippolito' juice grafted onto Citrus reshni had the highest levels of total hydroxycinnamic acids (263.33 mg L-1), total flavones (449.74 mg L-1) and total anthocyanins (650.42 mg L-1). To conclude, 'Tarocco Lempso' grafted onto Citrus macrophylla obtained the best values of agronomic parameters, and the cultivars grafted onto Citrus reshni obtained significantly higher concentrations in primary and secondary metabolites.

Favorable Neighborhood Walkability is Associated With Lower Burden of Cardiovascular Risk Factors Among Patients Within an Integrated Health System: The Houston Methodist Learning Health System Outpatient Registry.

This is the first study to investigate the relationship between neighborhood walkability and cardiovascular (CV) risk factors in the United States using a large population-based database. Cross-sectional study using data from 1.1 million patients over the age of 18 in the Houston Methodist Learning Health System Outpatient Registry (2016-2022). Using the 2019 WalkScore, patients were assigned to one of the 4 neighborhood walkability categories. The burden of CV risk factors (hypertension, diabetes, obesity, dyslipidemia, and smoking) was defined as poor, average, or optimal (>3, 1-2, 0 risk factors, respectively). We included 887,654 patients, of which 86% resided in the two least walkable neighborhoods. The prevalence of CV risk factors was significantly lower among participants in the most walkable neighborhoods irrespective of ASCVD status. After adjusting for age, sex, race/ethnicity, and socioeconomic factors, we found that adults living in the most walkable neighborhoods were more likely to have optimal CV risk profile than those in the least walkable ones (RRR 2.77, 95% CI 2.64-2.91). We observed an inverse association between neighborhood walkability and the burden of CV risk factors. These findings support multilevel health system stakeholder engagements and investments in walkable neighborhoods as a viable tool for mitigating the growing burden of modifiable CV risk factors.

Neighborhood deprivation and morbid obesity: Insights from the Houston Methodist Cardiovascular Disease Health System Learning Registry.

This study examined the relationship between a validated measure of socioeconomic deprivation, such as the Area Deprivation Index (ADI), and morbid obesity. We used cross-sectional data on adult patients (≥18 years) in the Houston Methodist Cardiovascular Disease Health System Learning Registry (located in Houston, Texas, USA) between June 2016 and July 2021. Each patient was grouped by quintiles of ADI, with higher quintiles signaling greater deprivation. BMI was calculated using measured height and weight with morbid obesity defined as ≥ 40 kg/m2. Multivariable logistic regression models were used to examine the association between ADI and morbid obesity adjusting for demographic (age, sex, and race/ethnicity) factors. Out of the 751,174 adults with an ADI ranking included in the analysis, 6.9 % had morbid obesity (n = 51,609). Patients in the highest ADI quintile had a higher age-adjusted prevalence (10.9 % vs 3.3 %), and about 4-fold odds (aOR, 3.8; 95 % CI = 3.6, 3.9) of morbid obesity compared to the lowest ADI quintile. We tested for and found interaction effects between ADI and each demographic factor, with stronger ADI-morbid obesity association observed for patients that were female, Hispanic, non-Hispanic White and 40-65 years old. The highest ADI quintile also had a high prevalence (44 %) of any obesity (aOR, 2.2; 95 % CI = 2.1, 2.2). In geospatial mapping, areas with higher ADI were more likely to have higher proportion of patients with morbid obesity. Census-based measures, like the ADI, may be informative for area-level obesity reduction strategies as it can help identify neighborhoods at high odds of having patients with morbid obesity.

Metabolomic Approach to Study the 'Purple Queen' Pomegranate Cultivar Response to Alternative Culture Media and Phenological Stages.

The increasingly evident threat of depletion of world peat bogs is encouraging the search for and study of alternative agricultural substrates that can fully or partially replace peat, guaranteeing food supply (quality and quantity). On the other hand, the identification of the potential for the reuse of waste from relevant economic activities has increased in recent years, mainly motivated by the change to a sustainable circular economy, as is the case of port sediments. Taking into account that significant volumes of dredged port sediments are generated annually so that ports can maintain their economic activity, it is necessary to find objective, sustainable and safe reuse alternatives. In this sense, the objective of this study was to study the response of the "Purple Queen" pomegranate when grown with dredged port sediment. For this, the fruit production (kg), number of fruits (fruits tree-1), fruit weight (g), and seed yield (%) aiming to verify the correct tree development were evaluated. In addition, a 1H-NMR foliar metabolomic study for the three most relevant phenological phases was performed (flowering, fruit development, and post-harvest) to identify metabolic changes in trees. In total, 29 metabolites were identified; among them, 11 were amino acids, 6 organic acids, 5 sugars, and 7 secondary metabolites. The good agronomical development of the trees and fruits indicated the potential for using the dredged sediment as an agricultural substrate. On the other hand, the results revealed that the greatest variability in the metabolomic study occurred between the phenological phases and a lower variability is explained by the substrates used.

Hospitalization and survival of solid organ transplant recipients with coronavirus disease 2019: A propensity matched cohort study.

BACKGROUND: Solid organ transplant (SOT) recipients are predicted to have worse COVID-19 outcomes due to their compromised immunity. However, this association remains uncertain because published studies have had small sample sizes and variability in chronic comorbidity adjustment. METHODS: In this retrospective cohort study conducted at a multihospital health system, we compared COVID-19 outcomes and survival up to 60 days following hospital admission in SOT recipients taking baseline immunosuppressants versus hospitalized control patients. RESULTS: The study included 4,562 patients who were hospitalized with COVID-19 (108 SOT recipients and 4,454 controls) from 03/2020 to 08/2020. Mortality at 60 days was higher for SOT recipients (17% SOT vs 10% control; unadjusted odds ratio (OR) = 1.74, 95% confidence interval (CI) 1.04-2.91, P = 0.04). We then conducted a 1:5 propensity matched cohort analysis (100 SOT recipients; 500 controls) using age, sex, race, body mass index, hypertension, diabetes, chronic kidney disease, liver disease, admission month, and area deprivation index. Within 28 days of admission, SOT recipients had fewer hospital-free days (median; 17 SOT vs 21 control; OR = 0.64, 95%CI 0.46-0.90, P = 0.01) but had similar ICU-free days (OR = 1.20, 95%CI 0.72-2.00, P = 0.49) and ventilator-free days (OR = 0.91, 95%CI 0.53-1.57, P = 0.75). There was no statistically significant difference in 28-day mortality (9% SOT vs 12% control; OR = 0.76, 95%CI 0.36-1.57, P = 0.46) or 60-day mortality (16% SOT vs 14% control; OR = 1.15, 95%CI 0.64-2.08, P = 0.64). CONCLUSIONS: Hospitalized SOT recipients appear to need additional days of hospital care but can achieve short-term mortality outcomes from COVID-19 that are similar to non-SOT recipients in a propensity matched cohort study.

Life Cycle Assessment (LCA) of Substrate Mixes Containing Port Sediments for Sustainable 'Verna' Lemon Production.

The increase in maritime trade and its global economic importance have forced port management actors to carry out the periodic dredging of their sediments to maintain an adequate depth for the passage of large ships to maintain their operation and competitiveness. During the dredging process, large volumes of port sediment are generated. Dredged port sediment is currently considered a waste material and its disposal is regulated. Finding ways to safely reuse port sediments is necessary for sustainable development. In this study, a life cycle assessment (LCA) methodology was applied to identify the environmental impact of port sediments when used as a culture medium for lemon trees. A total of 90 lemon trees (Citrus limon L. Burm var 'Verna') were used in the trial. The trees were grown under controlled conditions using three substrates, with different portions of peat and port sediment (25%, 50%, and 75%) to identify the real impacts of the culture media on the growth process. The LCA was calculated and analyzed according to the ISO 14040:2006 standard, using the SimaPro v. 9.3 software (PRé Sustainability B.V, Amersfoort, The Netherlands). The functional unit defined for the three-culture media was 1 kg of lemons. The LCA results showed a significant increase in the environmental impact of lemon cultivation proportional to port sediment content (75%), due to the decrease in fruit production caused by the sediment. However, the least impact was identified for the culture medium at 50% peat and 50% port sediment. The greatest impacts were more related to crop management rather than the port sediment content. The results showed that the use of the port sediment, mixed with other substrates as an agricultural medium amendment, is a viable option for lemon growers.

Decreased low-density lipoprotein receptor-related protein 1 expression in pro-inflammatory monocytes is associated with subclinical atherosclerosis.

Subclinical atherosclerosis (SCA) occurs in asymptomatic individuals. Blood peripheral monocytes are involved in the development of atherosclerosis. Circulating monocytes acquire pro-inflammatory profiles, and they are involved in the early stages of atherosclerosis development. Low-density lipoprotein Receptor-related Protein 1 (LRP1) is expressed in monocytes, mainly in classical and intermediate subsets. Although LRP1 is highly expressed in macrophages and vascular smooth muscle cells (VSMCs) in atherosclerotic plaque formation, its expression in circulating monocytes has not been studied in SCA. The aim of this study was to characterize the LRP1 expression level in circulating monocytes of individuals with SCA and compared with individuals with low (LR) and intermediate (IR) risk of cardiovascular diseases, both without evidence of atherosclerotic lesions in carotid and coronary arteries. LRP1 and additional markers (CD11b, CD11c, and CD36) at cell surface of monocytes were analyzed by flow cytometry assays, whereas LRP1 and pro-inflammatory factors gene expressions were measured in isolated monocytes by quantitative RT-PCRs. Both LRP1 protein and LRP1 mRNA were significantly reduced in monocytes in SCA and IR respect to LR. Conversely, CD36, CD11b, and CD11c monocytic markers showed no significant changes between the different study groups. Finally, increased gene expressions of TNF-α and IL-1ß were detected in monocytes of SCA, which were associated with decreased LRP1 expression at the cell surface in total monocytes. In summary, we propose that the decreased LRP1 expression at cell surface in total monocytes with pro-inflammatory profile is associated with the development of atherosclerosis in asymptomatic individuals.

Physico-Chemical Attributes of Lemon Fruits as Affected by Growing Substrate and Rootstock.

Due to its high content of bioactive compounds, the lemon is considered one of the most relevant species around the world. Its great economic importance is motivated, in addition to its fresh consumption, by its applications in the medical, pharmaceutical, and food industries, etc. However, the chemical and nutritional composition of lemon is not constant and can be influenced by external factors such as variety, weather conditions, crop management, etc. Determining the compositional variations of the fruit, essential to defining its potential use, was the main objective of this study. The physicochemical characteristics of the 'Verna' lemon were studied as a function of two controlled variables, the growing substrate and the rootstock. For this, 90 lemon trees were cultivated in three rootstocks and three different culture media. Lemon trees cultivated with 50% sediment/peat mix substrate presented a higher total production (590 lemons and 90.53 kg) while this production was 80% lower on trees cultivated with 75% marine sediment. Citrus macrophylla and Citrus aurantium/Citrus sinensis rootstocks showed a significantly higher production than the Citrus aurantium. All the fruits presented a predominantly yellow color appropriate for the market (0 < CI < +5). Nutritional and chemical parameters were consistent with data reported for the 'Verna' clones. All the obtained lemons were suitable for marketing and consumption both in fresh and processed forms. The results indicated the limited influence that the studied variables have on the quality parameters of lemon fruits, but they also could confirm the potential of marine sediment as a culture substrate.

Influence of fruit bagging technique on the morphometric and biochemical characteristics of two pomegranate varieties (Punica granatum L.).

The pomegranate tree is cultivated and its fruits consumed since ancient times. This tree is typical of the Mediterranean climate, with high thermal demands to mature properly. The main objective of this work was to study the influence of the fruit bagging technique on the morphometric and biochemical characteristics of the pomegranate fruits of two new varieties that are currently cultivated in the Southeast of Spain. The results indicated that the fruit bagging presented a significant effect on the weight, equatorial diameter, height and shape of the fruit, however, it did not show any influence on the peel thickness. No significant differences have been observed in the number of healthy fruits with and without bagging, however, the number of cracked fruits with Cryptoblabes gnidiella damage was higher for the non-bagged fruits. The fruit bagging presented a significant effect on the total soluble solids, maturity index, glucose, α-punicalagin, α + ß-punicalagin and ellagic acid, but it did not show influence on pH, acidity, ABTS, DPPH, FRAP, total phenols, fructose, citric, malic, and quinic acid, ß-punicalagin and anthocyanins. The internal fruit color was not affected by the bagging, although it did affect the external color of the fruit, and unevenly depending on the variety. Based on the results, it can be said that bagging can improve the quality of the fruit by reducing damage from pests and pathophysiology, and this benefit compensates or even exceeds the negative effects of bagging on peel color.

Breba Fruits Characterization from Four Varieties (Ficus carica L.) with Important Commercial Interest in Spain.

Although most of the published articles generalize with the fruit of the fig tree (Ficus carica L.), the differentiation between fig and breba is increasingly common in the bibliography. In this regard, keep in mind that the fig tree generally produces two crops a year, the parthenocarpic breba, also called as early fig, and the main non-parthenocarpic crop, the fig proper. In this study, four brebas varieties ('Colar', 'SuperFig1', 'Cuello de Dama Negro' and 'San Antonio') were selected in order to identify compositional, nutritional, and chemical diversity. These varieties were chosen for their commercial relevance in Spain. Color (internal and external), fruit and peel weight, size, pH, total soluble solids (TSS), titratable acidity (TA), maturity index (MI), sugar, and organic content were determined for all the breba fruits samples. In addition, polyphenolic profile, amino acids, and volatile aromatic compounds were also identified. The varieties 'Colar' and 'SuperFig1' showed the highest fruit weight and size, while 'Cuello de Dama Negro' presented the higher pulp yield. The higher organic acid and sugar contents were determined for 'SuperFig1' and 'Cuello de Dama Negro', respectively. Although in low concentrations, the phenolic compound quercetin 3-(6-O-acetyl-beta-glucoside) and the amino acid tyrosine were only detected in the ''Cuello de Dama Negra' and 'SuperFig1' fruits, respectively. Of the eighty volatile aromatic compounds identified, only eight were common in four varieties. An important knowledge gap was identified in relation to the characterization of the two Ficus carica L. crops, that is, the differentiation and specification in the literature when working with brebas and/or figs.

Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey.

BACKGROUND: Patient portals play an important role in connecting patients with their medical care team, which improves patient engagement in treatment plans, decreases unnecessary visits, and reduces costs. During natural disasters, patients' needs increase, whereas available resources, specifically access to care, become limited. OBJECTIVE: This study aims to examine patients' health needs during a natural crisis by analyzing the electronic messages sent during Hurricane Harvey to guide future disaster planning efforts. METHODS: We explored patient portal use data from a large Greater Houston area health care system focusing on the initial week of the Hurricane Harvey disaster, beginning with the date of landfall, August 25, 2017, to August 31, 2017. A mixed methods approach was used to assess patients' immediate health needs and concerns during the disruption of access to routine and emergent medical care. Quantitative analysis used logistic regression models to assess the predictive characteristics of patients using the portal during Hurricane Harvey. This study also included encounters by type (emergency, inpatient, observation, outpatient, and outpatient surgery) and time (before, during, and after Hurricane Harvey). For qualitative analysis, the content of these messages was examined using the constant comparative method to identify emerging themes found within the message texts. RESULTS: Out of a total of 557,024 patients, 4079 (0.73%) sent a message during Hurricane Harvey, whereas 31,737 (5.69%) used the portal. Age, sex, race, and ethnicity were predictive factors for using the portal and sending a message during the natural disaster. We found that prior use of the patient portal increased the likelihood of portal use during Hurricane Harvey (odds ratio 13.688, 95% CI 12.929-14.491) and of sending a portal message during the disaster (odds ratio 14.172, 95% CI 11.879-16.907). Having an encounter 4 weeks before or after Hurricane Harvey was positively associated with increased use of the portal and sending a portal message. Patients with encounters during the main Hurricane Harvey week had a higher increased likelihood of portal use across all five encounter types. Qualitative themes included: access, prescription requests, medical advice (chronic conditions, acute care, urgent needs, and Hurricane Harvey-related injuries), mental health, technical difficulties, and provider constraints. CONCLUSIONS: The patient portal can be a useful tool for communication between patients and providers to address the urgent needs and concerns of patients as a natural disaster unfolds. This was the first known study to include encounter data to understand portal use compared with care provisioning. Prior use was predictive of both portal use and message sending during Hurricane Harvey. These findings could inform the types of demands that may arise in future disaster situations and can serve as the first step in intentionally optimizing patient portal usability for emergency health care management during natural disasters.

Rapid Response to Drive COVID-19 Research in a Learning Health Care System: Rationale and Design of the Houston Methodist COVID-19 Surveillance and Outcomes Registry (CURATOR).

BACKGROUND: The COVID-19 pandemic has exacerbated the challenges of meaningful health care digitization. The need for rapid yet validated decision-making requires robust data infrastructure. Organizations with a focus on learning health care (LHC) systems tend to adapt better to rapidly evolving data needs. Few studies have demonstrated a successful implementation of data digitization principles in an LHC context across health care systems during the COVID-19 pandemic. OBJECTIVE: We share our experience and provide a framework for assembling and organizing multidisciplinary resources, structuring and regulating research needs, and developing a single source of truth (SSoT) for COVID-19 research by applying fundamental principles of health care digitization, in the context of LHC systems across a complex health care organization. METHODS: Houston Methodist (HM) comprises eight tertiary care hospitals and an expansive primary care network across Greater Houston, Texas. During the early phase of the pandemic, institutional leadership envisioned the need to streamline COVID-19 research and established the retrospective research task force (RRTF). We describe an account of the structure, functioning, and productivity of the RRTF. We further elucidate the technical and structural details of a comprehensive data repository-the HM COVID-19 Surveillance and Outcomes Registry (CURATOR). We particularly highlight how CURATOR conforms to standard health care digitization principles in the LHC context. RESULTS: The HM COVID-19 RRTF comprises expertise in epidemiology, health systems, clinical domains, data sciences, information technology, and research regulation. The RRTF initially convened in March 2020 to prioritize and streamline COVID-19 observational research; to date, it has reviewed over 60 protocols and made recommendations to the institutional review board (IRB). The RRTF also established the charter for CURATOR, which in itself was IRB-approved in April 2020. CURATOR is a relational structured query language database that is directly populated with data from electronic health records, via largely automated extract, transform, and load procedures. The CURATOR design enables longitudinal tracking of COVID-19 cases and controls before and after COVID-19 testing. CURATOR has been set up following the SSoT principle and is harmonized across other COVID-19 data sources. CURATOR eliminates data silos by leveraging unique and disparate big data sources for COVID-19 research and provides a platform to capitalize on institutional investment in cloud computing. It currently hosts deeply phenotyped sociodemographic, clinical, and outcomes data of approximately 200,000 individuals tested for COVID-19. It supports more than 30 IRB-approved protocols across several clinical domains and has generated numerous publications from its core and associated data sources. CONCLUSIONS: A data-driven decision-making strategy is paramount to the success of health care organizations. Investment in cross-disciplinary expertise, health care technology, and leadership commitment are key ingredients to foster an LHC system. Such systems can mitigate the effects of ongoing and future health care catastrophes by providing timely and validated decision support.

A new combined sensory-instrumental tool for pomegranate seed hardness determination.

BACKGROUND: Scanning electron microscopy was assayed and linked with previous data with respect to obtaining a new combined sensory-instrumental tool for pomegranate seed hardness determination. The present study aimed to develop an effective tool for the prediction of sensory properties via instrumental determinations. RESULTS: Simple regression analysis determined a high correlation within descriptive seed hardness and thickness of the wall, as well as descriptive wood perception and thickness of the wall, with values of 0.71 in both cases. Multiple regression analysis improved correlations when (i) descriptive seed hardness correlated with instrumental seed hardness and wood index (0.94); (ii) descriptive wood perception correlated with instrumental seed hardness and wood index (0.79); (iii) descriptive seed hardness correlated with instrumental seed hardness and thickness of the seed wall (0.96); and (iv) descriptive wood perception correlated with instrumental seed hardness and thickness of the seed wall (0.82). The same trend was found when (i) seed hardness satisfaction degree correlated with instrumental seed hardness and wood index (0.92); (ii) wood perception satisfaction degree correlated with instrumental seed hardness and wood index (0.82); (iii) seed hardness satisfaction degree correlated with instrumental seed hardness and thickness of the wall (0.99); and (iv) wood perception satisfaction degree correlated with instrumental seed hardness and thickness of the wall (0.99). CONCLUSION: Regarding mechanical properties, the results of the present study confirm that texture analysis and scanning electron microscopy are an effective tool for obtaining reliable information. This research led to establish an objective tool allowing prediction of the consumer acceptance of pomegranate cultivars worldwide. © 2020 Society of Chemical Industry.